Laparoscopic Surgery for Colovesical Fistula Caused by Colonic Diverticulitis: A Retrospective Study at a Single Center

TL;DR

This study shows that laparoscopic surgery for a rare condition called colovesical fistula is safe and effective, with results similar to standard surgeries for colonic diverticulitis.

Contribution

The paper introduces a standardized 'all-in-one' laparoscopic technique for colovesical fistulas caused by diverticulitis.

Findings

Laparoscopic surgery for colovesical fistulas had comparable operative times and outcomes to standard Hinchey I/II diverticulitis cases.

No conversions to open surgery or severe complications occurred in the fistula group.

Hospital stays and blood loss were similar between fistula and non-fistula cases.

Abstract

Background

Colovesical fistulas caused by colonic diverticulitis are relatively rare but require surgical intervention. Recent advancements have enabled laparoscopic approaches, although standard procedures are yet to be established.

Objective

To evaluate the safety and efficacy of laparoscopic surgery for colovesical fistula and compare outcomes with those for Hinchey I/II diverticulitis without fistulas.

Methods

We retrospectively reviewed 48 patients who underwent laparoscopic surgery for colonic diverticulitis from January 2015 to August 2024. Of these, nine had colovesical fistulas. Operative time, blood loss, and postoperative hospital stay were compared using Welch’s t-test.

Results

The mean operative time was 381.2 ± 175.0 min in the fistula group and 308.1 ± 120.5 min in the non-fistula group (p = 0.262). Mean blood loss was 162.8 ± 167.4 mL and 130.8 ± 197.7 mL, respectively (p = 0.626). Mean postoperative hospital stay was 7.7 ± 1.12 days and 7.4 ± 2.27 days (p = 0.626), respectively. There were no conversions to open surgery, and no recurrences or severe complications were observed.

Conclusion

Laparoscopic surgery for colovesical fistula is feasible and achieves outcomes comparable to standard cases of Hinchey I/II diverticulitis. A standardized "all-in-one" laparoscopic technique can be applied even in cases with fistulas.