When the bowel meets the bladder: Optimal management of colorectal pathology with urological involvement

作     者：Conor Keady Daniel Hechtl Myles Joyce 

作者机构：Department of Colorectal SurgeryGalway University HospitalGalway H91 YR71Ireland 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2020年第12卷第5期

页      面：208-225页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Colovesical fistula Enterovesical fistula Rectourinary fistula Intestinal fistula Diverticular fistula Diverticular disease Laparoscopic surgery Colorectal cancer 

摘      要：Fistulae between the gastrointestinal and urinary systems are rare but becoming increasingly more common in current surgical *** are a heterogeneous group of pathological entities that are uncommon complications of both benign and malignant *** the incidence of complicated diverticular disease and colorectal malignancy increases,so too does the extent of fistulous connections between the gastrointestinal and urinary *** complex problems will be more common as a factor of an aging population with increased life *** disease is the most commonly encountered aetiology,accounting for up to 80%of cases,followed by colorectal malignancy in up to 20%.A high index of suspicion is required in order to make the diagnosis,with ever improving imaging techniques playing an important role in the diagnostic *** strategies vary,with most surgeons now advocating for a single-stage approach to enterovesical fistulae,particularly in the elective *** bladder management techniques are also ***,open techniques were the standard;however,increased experience and advances in surgical technology have contributed to refined and improved laparoscopic ***,due to the relative rarity of these entities,no randomised studies have been performed to ascertain the most appropriate management *** fistulae have dramatically increased in incidence with advances in the non-operative management of prostate *** radiotherapy being a major contributing factor in the development of these complex fistulae,optimum surgical approach and exposure has changed accordingly to optimise their *** management in the form of diversion therapy is effective in temporising the situation and allowing for the diversion of faecal contents if there is associated soiling,macerated tissues or associated *** may plan for definitive surgical intervention