Objective:To explore the diagnosis and treatment of enterovesical fistula.Methods:The clinical data of 12 patients with enterovesical fistula at the First Affiliated Hospital of Soochow University from Jan 2012 to Dec 2021 were retrospectively analyzed.Results:There were 5 cases of rectovesical fistula, 4 cases of sigmoid colovesical fistula, 1 case of cecovesical fistula, and 2 cases of ileovesical fistula , with 1 female patient having concurrent vaginal vesical fistula . CT was carried out in 6 cases, enteroscopy in 5 cases, cystoscopy in 6 cases, cystography in 3 cases, and enterography in 2 cases. Eleven cases underwent surgical treatment, 1 case did not. Five cases underwent more than two operations, 1 case still had enterovesical fistula and died after ileostomy, 2 cases improved after enterotomy. One case underwent bowel resection and bladder repair and 3 cases underwent bowel resection and anastomosis combined with partial or total cystectomy, 4 cases underwent bowel resection, bladder repair, transverse colon or ileostomy. One died, 1 case still had enterovesical fistula and 10 cases were cured. There were no recurrence on follow-up.Conclusions:Enterovesical fistula is often secondary to intestinal tumors, and its clinical manifestations are mostly fecaluria and urinary tract infections. CT, cystoscopy, cystography and enterography are important diagnostic methods. Surgical treatment is the choice of therapy.

Objective:To explore the necessity of salvage surgery after endoscopic resection of early rectal cancer.Methods:The clinical data of 62 patients who underwent salvage surgery for early rectal cancer at the First Affiliated Hospital of Soochow University from Jan 2012 to Dec 2021 were retrospectively analyzed.Results:Six cases (10%) had residual tumors, 8 cases (13%) had lymph node metastasis and one case (2%) had cancer nodules; The operation time was (178±82) mins; 1 case (2%) developed anastomotic lerakage, which was cured; 2 cases (3%) developed intestinal obstruction, of which 1 case (2%) relieved on conservative management and 1 case (2%) underwent reoperation.Conclusion:It is necessary to perform salvage surgery for early rectal cancer patients with residual caner and risk factors of lymph node metastasis after endoscopic therapy.

Objective:To explore the diagnosis and treatment of intestinal endometriosis.Methods:The clinical data of 12 patients with intestinal endometriosis at the First Affiliated Hospital of Soochow University from Aug 2016 to Jan 2023 were retrospectively analyzed.Results:There were 8 cases of rectal endometriosis, 3 cases of sigmoid colon endometriosis and 1 case of ileal endometriosis. Nine cases underwent colonoscopy, 6 cases underwent CT examination, 3 cases underwent MRI examination, and 4 cases underwent transabdominal or vaginal ultrasnography. All 12 cases underwent operation, 8 cases were misdiagnosed as colorectal neoplasms and underwent intestinal resection, 1 case had right hemicolectomy because of ambiguous pathology, 2 cases with definite intestinal endometriosis underwent local intestinal resection, 1 case had transanal tumor excision with diagnosis confirmed by postoperative pathology; 5 cases underwent open surgery, 5 cases did laparoscopy, 1 case was done with robotic surgery, 1 case was by transanal surgery; 7 patients underwent more than 2 surgeries, with a maximal of 5 surgeries in one case. The hospital stay varied from 9 to 351 days, all 12 cases were cured, and follow-up found no recurrence.Conclusions:It is often difficult to make a clear diagnosis of intestinal endometriosis preoperatively.Many were misdiagnosed as colorectal neoplasms.Laparascopic exploration and biopsy help prevent inappropriate surgery.