Enterocutaneous fistula in patients with peritoneal malignancy following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Incidence, management and outcomes

Treatment-related post-operative mortality after cytoreductive surgery and perioperative intraperitoneal chemotherapy

“…Previous studies on ECF and PF reported that both ECF and PF were associated with longer hospital stay, but only ECF was linked to hospital mortality. 39,40 According to Berry et al (1996), 75-85% of gastrointestinal fistulas are due to bowel injury, inadvertent enterotomy and/or anastomotic leakage. 41 Valle et al (2016) reported that longer operating time and PCI were associated with an increased chance of ECF formation, with a greater number of bowel resections and enterotomies.…”

“…39,40 According to Berry et al (1996), 75-85% of gastrointestinal fistulas are due to bowel injury, inadvertent enterotomy and/or anastomotic leakage. 41 Valle et al (2016) reported that longer operating time and PCI were associated with an increased chance of ECF formation, with a greater number of bowel resections and enterotomies. 39 In addition, patients with ECF suffered from a greater number of complications, such as bleeding, pleural effusion, collection, and sepsis.…”

“…41 Valle et al (2016) reported that longer operating time and PCI were associated with an increased chance of ECF formation, with a greater number of bowel resections and enterotomies. 39 In addition, patients with ECF suffered from a greater number of complications, such as bleeding, pleural effusion, collection, and sepsis. 39 Our centre aims to manage ECF conservatively with total parenteral nutrition (TPN) and somatostatin analogues.…”

“…39 In addition, patients with ECF suffered from a greater number of complications, such as bleeding, pleural effusion, collection, and sepsis. 39 Our centre aims to manage ECF conservatively with total parenteral nutrition (TPN) and somatostatin analogues. This therapy results in spontaneous closure of ECFs in up to 50%, however failure of spontaneous closure increases the length of hospital stay, which may put patients at greater risks of other complications.…”

“…This therapy results in spontaneous closure of ECFs in up to 50%, however failure of spontaneous closure increases the length of hospital stay, which may put patients at greater risks of other complications. 39 Therefore, it may be helpful to identify those who are unlikely to achieve spontaneous closure and to consider treating them more aggressively with early surgical intervention. Current indications for surgical management at our institution include distal obstruction and failure of spontaneous closure after two months of conservative management.…”