Digestive Fistulas: The Challenge Continues

Abstract

The digestive fistulas correspond to abnormal communications between the digestive system and between this and the body surface. Even after many years of study on the subject, digestive fistulas continue to challenge surgeons and patients suffering harm, consuming fortunes in their treatment, as well as causing serious damage affected people, its due to high morbidity and mortality. This review aims to review the literature on the gastrointestinal fistula subject, focusing on etiology, pathophysiology, classification, diagnosis, current therapy and prognosis in order to revisit a highly important topic and continue helping clinicians, general surgeons and device digestive in combating this challenge for doctors and patients.

Incidence of colonic fistulas in patients with colon cancer submitted to robotic surgery versus laparoscopic colorectal surgery: a systematic review and meta-analysis protocol

“…Colonic fistulas are one of the main complications of this operation. The severity of the condition is due to the loss of volume of body fluids, which contain essential substances for life, promoting malnutrition and hydroelectrolytic disorders, in addition to increasing the susceptibility of patients to infections and sepsis, the main cause of mortality in these patients 11 19 20…”

“…Thus, postoperative complications, such as wound infection, sepsis and malnutrition, increase the length of hospital stay and the morbidity and mortality of operated patients 4. However, one of the most worrying and difficult-to-manage complications is the dehiscence of anastomoses and colonic fistulas 11…”

“…Its diagnosis is clinical but may require additional exams, such as radiography and CT, to aid in the differential diagnosis. Due to the interference in homoeostasis, this condition and treatment represent a challenge 11…”

Enhancing digestive fistula healing by the off-label use of a thermoresponsive vessel occluder polymer associated with esophageal stent placement: A case report

“…Fistulas are a challenging public health burden related to Crohn's disease or secondary to surgery affecting millions of people worldwide with a high morbidity [1][2][3][4]. We present evidence of the potential therapeutic benefit of an intra-fistula treatment with a thermoresponsive Poloxamer 407 gel (20%) as a fistula occluder.…”

Thermoresponsive Gel Embedded with Adipose Stem-Cell-Derived Extracellular Vesicles Promotes Esophageal Fistula Healing in a Thermo-Actuated Delivery Strategy

“…This is the case for fistulas, − which consist of abnormal connections between two organs or organ and skin . Fistulas are a major health problem related to Crohn’s disease or secondary to surgery, cancer therapy, or trauma, − affecting millions of people worldwide with a mortality rate of about 5%. − Current surgical, biomaterial, drug-based, or cell therapy approaches only provide poor and variable healing rates. On the one hand, biomaterials as fibrin glue and porcine plugs are applied locally for fistula therapy, but they are quite limited by abscess formation and spontaneous expulsion, respectively.…”