Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence
Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and t...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-021-01272-6 |
| _version_ | 1818832075685363712 |
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| author | Stefano Granieri Francesco Sessa Alessandro Bonomi Sissi Paleino Federica Bruno Andrea Chierici Ivano Massimiliano Sciannamea Alessandro Germini Riccardo Campi Michele Talso Antonio Facciorusso Gianfranco Deiana Sergio Serni Christian Cotsoglou |
| author_facet | Stefano Granieri Francesco Sessa Alessandro Bonomi Sissi Paleino Federica Bruno Andrea Chierici Ivano Massimiliano Sciannamea Alessandro Germini Riccardo Campi Michele Talso Antonio Facciorusso Gianfranco Deiana Sergio Serni Christian Cotsoglou |
| author_sort | Stefano Granieri |
| collection | DOAJ |
| description | Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria). |
| first_indexed | 2024-12-19T01:57:16Z |
| format | Article |
| id | doaj.art-5434ae8935f5431eb3dcc280e63013a7 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-19T01:57:16Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-5434ae8935f5431eb3dcc280e63013a72022-12-21T20:41:09ZengBMCBMC Surgery1471-24822021-05-0121111310.1186/s12893-021-01272-6Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalenceStefano Granieri0Francesco Sessa1Alessandro Bonomi2Sissi Paleino3Federica Bruno4Andrea Chierici5Ivano Massimiliano Sciannamea6Alessandro Germini7Riccardo Campi8Michele Talso9Antonio Facciorusso10Gianfranco Deiana11Sergio Serni12Christian Cotsoglou13General Surgery Unit, ASST Brianza, Vimercate HospitalUnit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of FlorenceUniversity of MilanGeneral Surgery Unit, ASST Brianza, Vimercate HospitalGeneral Surgery Unit, ASST Brianza, Vimercate HospitalGeneral Surgery Unit, ASST Brianza, Vimercate HospitalGeneral Surgery Unit, ASST Brianza, Vimercate HospitalGeneral Surgery Unit, ASST Brianza, Vimercate HospitalUnit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of FlorenceUrology Unit, ASST Brianza, Vimercate HospitalDepartment of Medical Sciences, Gastroenterology Unit, Ospedali Riuniti di FoggiaUrology Unit, ASST Brianza, Vimercate HospitalUnit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of FlorenceGeneral Surgery Unit, ASST Brianza, Vimercate HospitalAbstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).https://doi.org/10.1186/s12893-021-01272-6Colovesical fistulaEnterovesical fistulaSurgical managementSystematic reviewMeta-analysis |
| spellingShingle | Stefano Granieri Francesco Sessa Alessandro Bonomi Sissi Paleino Federica Bruno Andrea Chierici Ivano Massimiliano Sciannamea Alessandro Germini Riccardo Campi Michele Talso Antonio Facciorusso Gianfranco Deiana Sergio Serni Christian Cotsoglou Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence BMC Surgery Colovesical fistula Enterovesical fistula Surgical management Systematic review Meta-analysis |
| title | Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence |
| title_full | Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence |
| title_fullStr | Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence |
| title_full_unstemmed | Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence |
| title_short | Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence |
| title_sort | indications and outcomes of enterovesical and colovesical fistulas systematic review of the literature and meta analysis of prevalence |
| topic | Colovesical fistula Enterovesical fistula Surgical management Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s12893-021-01272-6 |
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