Evaluating surgical management and outcomes of colovaginal fistulas

Am J Surg. 2017 Mar;213(3):553-557. doi: 10.1016/j.amjsurg.2016.11.006. Epub 2016 Nov 14.

Abstract

Background: Colovaginal fistula is a rare condition associated with significant morbidity. The literature characterizing colovaginal fistula repair is sparse. We present our institution's experience treating colovaginal fistulas.

Methods: A retrospective review of all patients surgically treated for colovaginal fistula between 2005 and 2015 was performed. Patient demographics, intra-operative details, and post-operative outcomes were reviewed.

Results: We identified 27 patients with a mean age of 71 (±13) and BMI of 30 (±9). The most common etiology for fistula was diverticulitis (n = 24, 89%). A laparoscopic approach was initiated in 19 patients (70%) and an open approach for 8 (30%) with 8 patients converted from laparoscopy to open (42%). At a mean follow-up of 18 months (±21), there were no recurrences.

Conclusion: We present one of the largest series of the surgical management of colovaginal fistulas. Although our conversion rate was high, we recommend a laparoscopic approach be utilized when feasible.

Keywords: Colovaginal; Diverticulitis; Fistula; Laparoscopy.

MeSH terms

  • Aged
  • Conversion to Open Surgery / statistics & numerical data
  • Diverticulitis, Colonic / complications
  • Female
  • Follow-Up Studies
  • Humans
  • Intestinal Fistula / etiology
  • Intestinal Fistula / surgery*
  • Laparoscopy / statistics & numerical data
  • Postoperative Complications
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Vaginal Fistula / etiology
  • Vaginal Fistula / surgery*