Abstract

Enterovesical and colovesical fistulas are rare but debilitating conditions that commonly arise from diverticular disease, Crohn’s disease, malignancy, or radiation injury. Surgical intervention remains the definitive treatment, yet the optimal approach—laparoscopic versus open—varies significantly by clinical context. This study aimed to evaluate the comparative effectiveness, perioperative outcomes, and patient-reported experiences of surgical techniques used in the management of enterovesical and colovesical fistulas across different etiologies. A narrative review was conducted using 40 peer-reviewed studies identified through Semantic Scholar. Studies included adult patients undergoing surgical repair of fistulas by laparoscopic, open, or robotic techniques. Data extraction focused on surgical approach, perioperative outcomes, recurrence, mortality, and quality-of-life (QoL). Laparoscopic surgery was associated with lower complication rates, shorter hospital stays, and higher patient satisfaction in benign conditions, particularly diverticular diseases. Open surgery remained necessary in malignancy, Crohn’s disease, and radiation-induced cases, where inflammation, fibrosis, or oncologic requirements precluded minimally invasive access. Conversion rates varied by etiology and complication rates ranged widely, especially in malignancy and irradiated fields. Recurrence and 30-day mortality were low across all approaches. However, patient-reported outcomes were infrequently and inconsistently reported. Surgical management of enterovesical and colovesical fistulas must be tailored to disease etiology and anatomical complexity. Laparoscopic surgery is preferred in benign cases, while open approaches remain essential in complex or oncologic settings. The absence of standardized QoL reporting highlights a critical gap and underscores the need for patient-centered metrics in future research.

Key words: Enterovesical fistula, colovesical fistula, surgical techniques, patient-reported outcomes, minimally invasive surgery