부산대학교 도서관

We report the cases of three male patients who underwent laparoscopic surgery (mean age, 71 years) for sigmoid-vesical fistula due to colonic diverticulitis. Pneumaturia was the chief complaint in two patients, while the remaining patient was asymptomatic. Primary anastomosis was achieved after laparoscopic resection of the fistula and the affected part of the sigmoid colon. One patient with a history of ischemic colitis required temporary ileostomy. Resection of urinary bladder fistula was not performed in any patient. The median duration of surgery was 359 min (range, 344-403 min), and the median intraoperative blood loss was 120 mL (minimum amount, 250 mL). No patient required conversion to laparotomy. Furthermore, there were no postoperative complications, and the mean hospital stay after surgery was 17 days (range, 15-19 days). The results of a literature review of 24 cases reported in Japan revealed that resection of urinary bladder fistula is not necessary in laparoscopic surgery for a sigmoid-vesical fistula and that good results can be achieved by sigmoidectomy of the section containing the fistula.