Somatostatin in the management of gastrointestinal fistulas

Torres, AJ; Landa, J.I.; Moreno, M. J. Oruezábal; Arguello, JM; Silecchia, G.; Gómez, Maria del Carmen Jurado; Hernández, F.; Jover, José María; Moreno, Enrique; Jl, Balibrea

doi:10.1016/0167-0115(92)90442-w

Cited by 22 publications

(30 citation statements)

References 1 publication

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“…However, high-output fistulas have been associated with significantly greater mortality [9,13]. Somatostatin and its synthetic analog, octreotide, inhibit the secretion of many GI hormones and have been used to reduce fistula output, although the results have been inconsistent in the reduction of fistula output and in the time to closure [14][15][16][17]. However, they may prove to be useful for wound management in patients with high-output fistulas that are difficult to contain.…”

Section: Preoperative Carementioning

confidence: 99%

Abdominal wall reconstruction in patients with enterocutaneous fistulas

Latifi

Gustafson

2011

Eur J Trauma Emerg Surg

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Enterocutaneous fistulas (ECFs) remain a feared complication of surgery, particularly in acute care and trauma patients. Despite advances in medical and surgical therapies, ECFs are associated with significant morbidity and mortality; in addition, significant health care resources are consumed in their treatment. Because of the frequency nowadays of open-abdomen and damage-control surgery, of aggressive treatment for abdominal compartment syndrome, and of necrotizing soft tissue infections of the abdominal wall, ECFs are becoming common; so are enteroatmospheric fistulas (EAFs), which represent a new entity where the lumen of the intestine is directly exposed to the outside environment and has no track through subcutaneous or cutaneous tissue. The surgical management of abdominal wall defects, including ECFs and/or EAFs, is often associated with major hernias and other complexities. Careful planning and advanced surgical techniques are required, often involving the use, alone or in combination, of biologic mesh and composite tissue transfer. The treatment of ECFs in patients with large abdominal wall defects is challenging, but with proper techniques, the results can be excellent. Biologic mesh is the mesh of choice in such patients.

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Section: Preoperative Carementioning

confidence: 99%

Abdominal wall reconstruction in patients with enterocutaneous fistulas

Latifi

Gustafson

2011

Eur J Trauma Emerg Surg

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“…3). One study did not have any deaths in either group, and therefore it could not be included in the statistical analysis [18]. There was a trend toward decreased mortality with somatostatin analogues; however, this was not statistically significant [RR 0.87 (95% CI 0.49-1.55)].…”

Section: Mortalitymentioning

confidence: 86%

“…Five studies had an unclear assessment for selective reporting bias as no published protocols were available and some patient important outcomes were not addressed in the study. The remaining three studies addressed all of the patient important outcomes addressed in the present review; therefore we deemed these studies to be free of selective reporting [12,15,18]. The inter-observer agreement for risk of bias assessment was excellent (kappa = 0.74).…”

Section: Study Characteristicsmentioning

confidence: 98%

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Somatostatin Analogues for the Treatment of Enterocutaneous Fistulas: A Systematic Review and Meta‐analysis

et al. 2012

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“…The potential role of somatostatin and octreotide in the treatment of enterocutaneous fistulas is obvious; unfortunately, the use of these substances in patient management has not significantly improved outcome [19,21]. Randomized controlled trials comparing the use of somatostatin combination with conservative measures including TPN to conservative measures alone demonstrated an inconsistent decrease in fistula output and time to closure, but did not show an increase in the rate of non-operative closure [22]. Randomized controlled trials comparing the use of octreotide with nonoperative therapy similarly failed to demonstrate a consistent decrease in fistula output, time to closure, or closure rate [23][24][25].…”

Section: Choice Of Enteral (En) or Total Parenteral Nutrition (Tpn): mentioning

confidence: 99%

Nutritional support in patients with gastrointestinal fistula

Yanar

2011

Eur J Trauma Emerg Surg

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Gastrointestinal fistulas (GIFs) arise as a complication of the surgical treatment of a number of malignant and non-malignant diseases. Fluid loss and electrolyte and nutritional imbalance are related to increased morbidity and mortality in these patients. A multidisciplinary approach under the leadership of the surgeon is essential for successful therapy. Because complication rates are higher in malnourished patients with fistulas, enteral or total parenteral nutritional (TPN) support should be initiated after the patient has been stabilized with respect to fluid loss, acid-base, and sepsis. Pharmacotherapy with somatostatin and octreotide has been shown to reduce fistula output and shorten closure time.

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Somatostatin in the management of gastrointestinal fistulas

Cited by 22 publications

References 1 publication

Abdominal wall reconstruction in patients with enterocutaneous fistulas

Abdominal wall reconstruction in patients with enterocutaneous fistulas

Somatostatin Analogues for the Treatment of Enterocutaneous Fistulas: A Systematic Review and Meta‐analysis

Nutritional support in patients with gastrointestinal fistula

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