12年的膀胱肠道瘘治疗经验。
A 12-year experience with enterovesical fistulas.
作者信息
McBeath R B, Schiff M, Allen V, Bottaccini M R, Miller J I, Ehreth J T
机构信息
Department of Surgery, University of Arizona Health Sciences Center, Tucson.
出版信息
Urology. 1994 Nov;44(5):661-5. doi: 10.1016/s0090-4295(94)80200-9.
OBJECTIVES
To review our experience with enterovesical fistulas in order to determine the most accurate diagnostic studies and most effective method of treatment.
METHODS
A retrospective record review of 76 patients who were diagnosed and treated for enterovesical fistulas over a 12-year period was performed. Data collection focused on presenting symptoms, urinary disease process, diagnostic studies, and methods of management.
RESULTS
Diverticular disease was the primary etiologic factor in the majority of patients (59%), with colonic malignancy, granulomatous bowel disease, and radiation therapy accounting for the majority of the remainder. Cystoscopy (60%) and cystography (44%) were the most sensitive diagnostic studies. There was no statistical difference in the complication rate between groups treated with single or multistage repair.
CONCLUSIONS
One-stage repair of enterovesical fistulas can be safely performed when the cause is diverticular or granulomatous bowel disease. Staged repairs may be more judicious in patients with large intervening pelvic abscesses or those in whom advanced malignancy or radiation changes are present.
目的
回顾我们在膀胱肠瘘方面的经验，以确定最准确的诊断研究方法和最有效的治疗方法。
方法
对76例在12年期间被诊断并接受膀胱肠瘘治疗的患者进行回顾性记录审查。数据收集集中在呈现的症状、泌尿系统疾病过程、诊断研究和管理方法上。
结果
憩室病是大多数患者（59%）的主要病因，其余大多数患者病因是结肠恶性肿瘤、肉芽肿性肠病和放射治疗。膀胱镜检查（60%）和膀胱造影（44%）是最敏感的诊断研究方法。单阶段或多阶段修复治疗组之间的并发症发生率无统计学差异。
结论
当病因是憩室或肉芽肿性肠病时，膀胱肠瘘的一期修复可以安全进行。对于有较大盆腔间位脓肿的患者或存在晚期恶性肿瘤或放射改变的患者，分期修复可能更为明智。
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