Management of enterocutaneous fistulae:A 10 years experience  

作　　者：Deepa Taggarshe Daniel Bakston Michael Jacobs Alasdair McKendrick Vijay K Mittal 

机构地区：[1]Department of Surgery,Providence Hospital and Medical Centers,16001 West Nine Mile Road,Southf ield,MI 48075,United States

出　　处：《World Journal of Gastrointestinal Surgery》2010年第7期242-246,共5页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM:To compare the outcomes of conservative vs surgical treatment of enterocutaneous fistulae(ECF) in a community teaching hospital over a decade.METHODS:All cases of ECF between 1997 and 2007 were reviewed for management strategy.RESULTS:Of the 83 patients with ECF,60(72%) were postoperative.Sixty-six patients(79.5%) were treated initially with conservative measures.Eighteen patients failed to respond to conservative treatment and required later(secondary) exploration;this group consisted of an equal number of low vs high output fistulae.Seventeen(20.5%) patients underwent initial(primary) def initivesurgery secondary to anastomotic leak and peritonitis.Surgical procedures included resection of ECF with anastomosis(24),exclusion(6) and direct-drainage(4).No signif icant difference was seen in the recurrence rate for conservative(10%) vs operative-treatment(20%).role as an initial management in both low and high output fistulae.In selective cases only,early primary exploration is recommended.AIM: To compare the outcomes of conservative vs surgical treatment of enterocutaneous fistulae (ECF) in a community teaching hospital over a decade.METHODS: All cases of ECF between 1997 and 2007 were reviewed for management strategy.RESULTS: Of the 83 patients with ECF, 60 (72%) were postoperative. Sixty-six patients (79.5%) were treated initially with conservative measures. Eighteen patients failed to respond to conservative treatment and required later (secondary) exploration; this group consisted of an equal number of low vs high output fistulae. Seventeen (20.5%) patients underwent initial (primary) definitive-surgery secondary to anastomotic leak and peritonitis. Surgical procedures included resection of ECF with anastomosis (24), exclusion (6) and direct-drainage (4). No significant difference was seen in the recurrence rate for conservative (10%) vs operative-treatment (20%).CONCLUSION: Conservative treatment plays a pivotal role as an initial management in both low and high output fistulae. In selective cases only, early primary exploration is recommended.

关 键 词：Low-output High-output Enterocutaneous FISTULAE 

分 类 号：R657.1[医药卫生—外科学]