Fistuloclysis

Willcutts, Kate; Mercer, David F.; Ziegler, Jane

doi:10.1097/won.0000000000000166

Cited by 13 publications

(8 citation statements)

References 21 publications

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“…Fistuloclysis is an option that can provide nutritional support for those fistulas that cannot close spontaneously ( 56 , 57 ). After completing the investigation of intestinal integrity and length of the small intestine beyond the distal fistula, a balloon Foley catheter was intubated into the fistula.…”

Section: Fistuloclysismentioning

confidence: 99%

Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression

et al. 2020

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The management of enterocutaneous fistulas (ECF) can be challenging because of massive fluid loss, which can lead to electrolyte imbalance, severe dehydration, malnutrition and sepsis. Nutritional support plays a key role in the management and successful closure of ECF. The principle of nutritional support for patients with ECF should be giving enteral nutrition (EN) priority, supplemented by parenteral nutrition if necessary. Although total parenteral nutrition (TPN) may be indicated, use of enteral feeding should be advocated as early as possible if patients are tolerant to it, which can protect gut mucosal barrier and prevent bacterial translocation. A variety of methods of enteral nutrition have been developed such as fistuloclysis and relay perfusion. ECF can also be occluded by special devices and then EN can be implemented, including fibrin glue application, Over-The-Scope Clip placement and three-dimensional (3D)-printed patient-personalized fistula stent implantation. However, those above should not be conducted in acute fistulas, because tissues are edematous and perforation could easily occur.

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Section: Fistuloclysismentioning

confidence: 99%

Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression

et al. 2020

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“…Even though it has been the main nutritional approach adopted, TPN has negative repercussions on treatment and requires proper care. Among the complications are liver dysfunction, catheter infections, and hyperglycemia [2][3][4][8][9][10][11]14,[16][17][18]22,24,[26][27][28] .…”

mentioning

confidence: 99%

“…As the nutrition of the patient with an EAF has an extremely important role in the management of the case, for the reduction of morbidity and mortality, care must be taken in defining the treatment. The exclusive parenteral route, even though it is the most widely used option, carries relevant secondary risks and high costs to the patient 3,7,8,10,11,14,15,17,18,20,[24][25][26][27][28] .…”

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confidence: 99%

“…By using the enteral route, which is more physiological in principle, the mesenteric perfusion is stimulated by mesenteric postprandial blood flow, the structural and functional integrity of the GI tract mucosa is increased, bacterial adhesion to the intestinal epithelial cells is prevented, with greater stimulation of IgA secretion and less local inflammatory response. These factors enhance the trophism of the local mucosa, in the longterm will provide better results in the definitive surgery for the reconstruction of intestinal transit [11][12][13][14]16,26,28,30 .…”

mentioning

confidence: 99%

“…When enteric, enterocutaneous fistulas represent a connection between the gastrointestinal tract and the skin. Another complex kind of fistula is represented by the enteroatmospheric fistulas (EAF), in which the origin is the gastrointestinal (GI) tract in connection with the external environment through an open abdomen 2,3,7,9,11,12,14,18,20,21,23,26,28 . In the case of EAF, most of them are complications of intestinal perforations, abdominal operations such as resection of the colon and/or rectum, surgical re-explorations, anastomotic fistulas and complex abdominal traumas.…”

mentioning

confidence: 99%

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The Role of Fistuloclysis in the Treatment of Patients With Enteroatmospheric Fistulas

Ribeiro-Júnior

Yeh

Augusto

et al. 2021

ABCD, arq. bras. cir. dig.

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Background: Enterocutaneous fistulas represent a connection between the gastrointestinal tract and adjacent tissues. Among them, there is a subdivision - the enteroatmospheric fistulas, in which the origin is the gastrointestinal tract in connection with the external environment through an open wound in the abdomen. Due to the high output in enterocutaneous fistulas, the loss of fluids, electrolytes, minerals and proteins leads to complications such as sepsis, malnutrition and electrolyte derangements. The parenteral nutrition has its secondary risks, and the fistuloclysis, that consist in the infusion of enteral feeding and also the chyme through the distal fistula, represents an alternative to the management of these patients until the definitive surgical approach. Aim: To evaluate the current evidence on the fistuloclysis technique, its applicability, advantages and disadvantages for patients with high output fistulas. Method: A systematic literature search was conducted in May 2020 with the headings “fistuloclysis”, “chyme reinfusion” and “succus entericus reinfusion”, in the PubMed, Medline and SciELO databases. Results: There were 29 articles selected for the development of this narrative synthesis, from 2003 to 2020, including reviews and case reports. Conclusion: Fistuloclysis is a safe method which optimizes the clinical, nutritional, and immunological conditions of patients with enteroatmospheric fistulas, increasing the chances of success of the reconstructive procedure. In cases where the definitive repair is not possible, chances of reducing or even stopping the use of nutrition through the parental route are increased, thus representing a promising modality for the management of most challenging cases.

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Nutrition Management of the High‐Output Fistulae

et al. 2020

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Enterocutaneous fistulae (ECFs) are commonly encountered complications in medical and surgical practice. High-output fistulae are associated with significant morbidity and mortality, poor quality of life, and a substantial healthcare burden. An interdisciplinary team approach is crucial to prevent and mitigate the adverse clinical consequences of high-output ECFs including sepsis, metabolic derangements, and malnutrition. Patients with ECFs are at a significantly higher risk of developing malnutrition and close monitoring by nutrition support professionals and/or a nutrition support team is an essential component of their medical management. High-output ECFs often require the initiation of nutrition support through either enteral or parenteral routes. Historically, parenteral nutrition (PN) has been the primary method of nutrition support in these patients. However, oral and enteral nutrition (EN) should remain viable options if an evaluation of the location of the ECF, amount of remaining functional bowel, and volume of ECF output identifies favorable conditions. Additionally, in contrast to PN, oral nutrition and EN are the preferred method of feeding because of the maintenance of the structural and functional integrity of the gastrointestinal tract. The inclusion of pharmacological interventions can greatly assist with the reduction and stabilization of ECF output and thereby permit sustained enteral feeding. Initiation of supplemental or full PN will be required if oral nutrition and EN lead to metabolic derangements, fail to meet energy requirements, or do not maintain or improve the patient's nutrition status. The main focus of this review is to discuss the nutrition management of patients with high-output ECFs.

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Fistuloclysis

Cited by 13 publications

References 21 publications

Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression

Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression

The Role of Fistuloclysis in the Treatment of Patients With Enteroatmospheric Fistulas

Nutrition Management of the High‐Output Fistulae

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