Treatment of colo-vesical fistulas: Predictive factors of long term digestive continuity.

Aim of the study: Colovesical fistulas (CVF) may occur in inflammatory or t umoral pelvic diseases. The aim of this study was to analyze the surgical m anagement of patients with a CVF in order to define predictive factors of g ood results and long term digestive continuity. Patients and methods: From 1989 to 1999, this retrospective study included 37 patients, 19 men and 18 women, mean age: 69 years (range 37-93 years). M ain etiologies were colonic diverticulitis (n=22) in 60% of the patients, c ancer (n=6) in 16%, previous radiotherapy (n=5) in 14%. Treatment was a div erting colostomy in 13 cases, a colectomy in 24 cases without diverting col ostomy in 10 cases. Results: Overall postoperative mortality rate was 16%. With a mean follow-u p of 47 months, digestive continuity was restored in 40% of the patients (1 00% in ASA 1 patients, 55% in ASA 2, 19% in ASA 3 and 0% in ASA 4). Conclusions: Our study suggests that long term digestive continuity followi ng surgical treatment of colovesical fistulas does not depend upon etiology or surgical treatment but mainly upon the patient's ASA score. (C) 2001 Ed itions scientifiques et medicales Elsevier SAS.