Endoscopic approach to diverticular fistula
https://doi.org/10.31146/2415-7813-endo-67-4-25-30
Abstract
Diverticular disease of the colon is the most common disease of the colon. In some cases, diverticular disease may be complicated by fistula. According to clinical guidelines resection of the bowel carrying the fistula is the method of choice. In a number of cases, surgical treatment may be contraindicated in case of pronounced somatic aggravation of the patient. The electronic databases Elibrary.ru, PubMed, Medline, Cochrane were searched for scientific studies on endoscopic treatment of patients with diverticular disease complicated by fistula formation in the period from 1993 to 2024. To date, there are no large studies on minimally invasive ways to eliminate fistulae complicating diverticular disease.
About the Authors
T. A. Savitskaya
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
A. A. Likutov
Ryzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
O. M. Yugai
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
A. I. Moskalev
Ryzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
References
1. Российская гастроэнтерологическая ассоциация, Ассоциация колопроктологов России. Клинические рекомендации Дивертикулярная болезнь.
2. Tănase I, Păun S, Stoica B, et al. Epidemiology of diverticular disease - systematic review of the literature. Chir Buchar Rom 1990. 2015;110:9-14.
3. Минушкин ОН, Кручинина МА, Алтухова ЕИ, et al. Дивертикулярная болезнь толстой кишки: диагностика, лечение, профилактика осложнений. Медицинский Совет. 2022;16:109-15. doi: doi.org/10.21518/2079-701X-2022-16-6-109-115
4. Nagata N, Niikura R, Aoki T, et al. Increase in colonic diverticulosis and diverticular hemorrhage in an aging society: lessons from a 9-year colonoscopic study of 28,192 patients in Japan.Int J Colorectal Dis. 2014;29:379-85. doi: 10.1007/s00384-013-1808-4
5. Niikura R, Yasunaga H, Yamaji Y, et al. Factors affecting in-hospital mortality in patients with lower gastrointestinal tract bleeding: a retrospective study using a national database in Japan. J Gastroenterol. 2015;50:533-40. doi: 10.1007/s00535-014-0994-3
6. Strate LL, Ayanian JZ, Kotler G, et al. Risk factors for mortality in lower intestinal bleeding. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2008;6:1004-10; quiz 955-. doi: 10.1016/j.cgh.2008.03.021
7. Kruis W, Germer C-T, Böhm S, et al. German guideline diverticular disease/diverticulitis: Part I: Methods, pathogenesis, epidemiology, clinical characteristics (definitions), natural course, diagnosis and classification. United Eur Gastroenterol J. 2022;10:923-39. doi: 10.1002/ueg2.12309
8. Peery AF, Shaukat A, Strate LL. AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review. Gastroenterology. 2021;160:906-911.e1. doi: 10.1053/j.gastro.2020.09.059
9. Beddy D, Wolff B. Advances and Dilemmas in Diverticular Disease: Surgery for Recurrent Diverticulitis. J Clin Gastroenterol. 2011;45: S74. doi: 10.1097/MCG.0b013e31820ca683
10. Kruis W, Germer C, Böhm S, et al. German guideline diverticular disease/diverticulitis. United Eur Gastroenterol J. 2022;10:940-57. doi: 10.1002/ueg2.12313
11. Nagata N, Ishii N, Manabe N, et al. Guidelines for Colonic Diverticular Bleeding and Colonic Diverticulitis: Japan Gastroenterological Association. Digestion. 2019;99 Suppl 1:1-26. doi: 10.1159/000495282
12. Schultz JK, Azhar N, Binda GA, et al. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon. Colorectal Dis. 2020;22:5-28. doi: 10.1111/codi.15140
13. Zizzo M, Tumiati D, Bassi MC, et al. Management of colovesical fistula: a systematic review. Minerva Urol Nephrol. 2022;74:400-8. doi: 10.23736/S2724-6051.21.04750-9
14. Cwikiel W, Andrén-Sandberg A. Malignant stricture with colovesical fistula: stent insertion in the colon. Radiology. 1993;186:563-4. doi: 10.1148/radiology.186.2.8421765
15. Kyoto Y, Iwasaki Y, Kaji T, et al. Gastrointestinal fistulas: treatment with covered stents. Abdom Imaging. 2001;26:570-3. doi: 10.1007/s002610000170
16. Bège T, Emungania O, Vitton V, et al. An endoscopic strategy for management of anastomotic complications from bariatric surgery: a prospective study. Gastrointest Endosc. 2011;73:238-44. doi: 10.1016/j.gie.2010.10.010
17. Ahmad M, Nice C, Katory M. Covered metallic stents for the palliation of colovesical fistula. Ann R Coll Surg Engl. 2010;92: W43-45. doi: 10.1308/147870810X12699662981555
18. Abel ME, Chiu YS, Russell TR, et al. Autologous fibrin glue in the treatment of rectovaginal and complex fistulas. Dis Colon Rectum. 1993;36:447-9. doi: 10.1007/BF02050009
19. Studniarek A, Abcarian A, Pan J, et al. What is the best method of rectovaginal fistula repair? A 25-year single-center experience. Tech Coloproctology. 2021;25:1037-44. doi: 10.1007/s10151-021-02475-y
20. Raymer GS, Sadana A, Campbell DB, et al. Endoscopic clip application as an adjunct to closure of mature esophageal perforation with fistulae. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2003;1:44-50. doi: 10.1053/jcgh.2003.50007
21. Kirschniak A, Kratt T, Stüker D, et al. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endosc. 2007;66:162-7. doi: 10.1016/j.gie.2007.01.034
22. von Renteln D, Vassiliou MC, Rothstein RI. Randomized controlled trial comparing endoscopic clips and over-the-scope clips for closure of natural orifice transluminal endoscopic surgery gastrotomies. Endoscopy. 2009;41:1056-61. doi: 10.1055/s-0029-1215241
23. von Renteln D, Denzer UW, Schachschal G, et al. Endoscopic closure of GI fistulae by using an over-the-scope clip (with videos). Gastrointest Endosc. 2010;72:1289-96. doi: 10.1016/j.gie.2010.07.033
24. Weiland T, Fehlker M, Gottwald T, et al. Performance of the OTSC System in the endoscopic closure of gastrointestinal fistulae - a meta-analysis. Minim Invasive Ther Allied Technol MITAT Off J Soc Minim Invasive Ther. 2012;21:249-58. doi: 10.3109/13645706.2012.694367
25. Bartell N, Bittner K, Kaul V, et al. Clinical efficacy of the over-the-scope clip device: A systematic review. World J Gastroenterol. 2020;26:3495-516. doi: 10.3748/wjg.v26.i24.3495
26. Haito-Chavez Y, Law JK, Kratt T, et al.International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video). Gastrointest Endosc. 2014;80:610-22. doi: 10.1016/j.gie.2014.03.049
27. Mercky P, Gonzalez J-M, Aimore Bonin E, et al. Usefulness of over-the-scope clipping system for closing digestive fistulas. Dig Endosc Off J Jpn Gastroenterol Endosc Soc. 2015;27:18-24. doi: 10.1111/den.12295
28. DeLong CG, Scow JS, Morrell DJ, et al. Endoscopic management of colovesical and colovaginal fistulas with over-the-scope clips: A single-institution case series. Colorectal Dis Off J Assoc Coloproctology G B Irel. 2022;24:314-21. doi: 10.1111/codi.15987
29. Sandmann M, Heike M, Faehndrich M. Application of the OTSC system for the closure of fistulas, anastomosal leakages and perforations within the gastrointestinal tract. Z Gastroenterol. 2011;49:981-5. doi: 10.1055/s-0029-1245972
30. Velayos B, Del Olmo L, Merino L, et al. Non-visible colovesical fistula located by cystoscopy and successfully managed with the novel Padlock® device for endoscopic closure.Int J Colorectal Dis. 2018;33:827-9. doi: 10.1007/s00384-018-3008-8
31. Liu AT, Knoedler JJ, Scow JS, et al. Endoscopic closure of diverticular-related colovesicular fistula - a video vignette. Colorectal Dis Off J Assoc Coloproctology G B Irel. 2020;22:2350-1. doi: 10.1111/codi.15327
Review
For citations:
Savitskaya T.A., Likutov A.A., Yugai O.M., Moskalev A.I. Endoscopic approach to diverticular fistula. Filin’s Clinical endoscopy. 2025;67(4):25-30. (In Russ.) https://doi.org/10.31146/2415-7813-endo-67-4-25-30
Views:
106
JATS XML
Email this article 