Treatment of High‐output Enterocutaneous Fistulas with a Vacuum‐compaction Device. A Ten‐year Experience

Wainstein, Daniel E.; Fernández, Ernesto; González, Daniel; Chara, Osvaldo; Berkowski, Dario

doi:10.1007/s00268-007-9235-8

Cited by 60 publications

(31 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Approximately, one-third of enterocutaneous fistulae will close spontaneously with proper supportive care, control of sepsis, and nutritional support [30]. Wainstein et al [31] reported that fistulae healed spontaneously in 46 % of patients, within a mean period of 90 days (range 8–370 days). Peng et al [32] reported that irrigation-suction through the drainage tubes was effective in approximately 75 % of patients with leakage, without the need for surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery

et al. 2013

View full text Add to dashboard Cite

PurposeTo improve the selection of patients for percutaneous abscess drainage (PAD) to treat postoperative intra-abdominal abscess after gastrointestinal surgery, we investigated the factors predictive of outcome.MethodsOf 143 consecutive patients with symptomatic postoperative intra-abdominal abscess after a gastrointestinal tract resection, 104 who underwent image-guided PAD as the initial treatment were reviewed. We assessed the possible associations between successful PAD and patient-, abscess-, surgical-, and drainage-related variables, and investigated the success rates of PAD for patients with vs. those without the factors related to successful outcome.ResultsBased on monitoring for 1 year after PAD, the success rate of this procedure was 85.6 % (89/104). Multivariate analysis revealed that the interval between surgery and the onset of abscess (p = 0.0234) and a single abscess (p = 0.0038) were independently associated with a successful outcome. Single late-onset abscess resolved completely within 10 weeks in 91.4 % of these patients.ConclusionsDespite new strategies aimed at preventing surgical site infection, PAD remains an important factor in the postoperative management of gastrointestinal surgery in Japan. Initial recognition of the day of onset and the number of abscesses are important prognostic factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Generally, management of bowel fistulae revolves around nutrition, diversion or reoperation, and treatment of sepsis. [6970]…”

Section: Discussionmentioning

confidence: 99%

Perioperative morbidity of radical cystectomy: A review

Kulkarni¹

2011

Indian J Urol

View full text Add to dashboard Cite

A systematic review of the literature on perioperative morbidity (POM) was done using Medline software with a combination of keywords like mortality, morbidity, and complications. In addition, we review the analysis of our hospital data of 261 Radical cystectomies (RCs) performed in an 11-year period and our latest clinical pathway for RC. Age range in our series was 50 to 81 years with 240 males and 21 females. RCs were performed by intraperitoneal method in 172 patients and by our extraperitoneal (EP) method in 89 patients. Urinary diversion was ileal conduit in 159 patients and neobladder in 102 patients. Blood loss ranged between 500 and 1500 ccs. Postoperative mortality occurred in eight patients (3%). Among the other early post-op complications, major urinary leak was seen in nine and minor in 11, requiring PCN in five patients and reoperation in four patients. Bowel leak or obstruction was seen in six and four patients, respectively, requiring reoperation in six patients. EP RC in our series showed some benefit in reduction of POM. The mortality of RC has declined but the POM still ranges from 11 to 68%, as reported in 23 series (1999-2008) comprising of 14 076 patients. Various risk factors leading to POM and some corrective measures are discussed in detail. However, most of these series are retrospective and lack standard complication reporting, which limits the comparison of outcomes. Various modifications in open surgical technique and laparoscopic and Robotic approaches are aimed at reduction in mortality and POM of RC.

show abstract

“…Advances in parenteral nutrition (PN), radiological diagnosis, and treatment of intraabdominal abscesses and antibiotics among others have led to a decrease in mortality rates which were previously reported at ∼40% to the current ∼10%. [1][2][3] When initially diagnosed most patients already suffer at least one of the frequent complications related to ECF such as sepsis, malnutrition, and fluid and electrolyte imbalance; these are the main causes of morbidity and mortality. Medical therapy aims to treat these complications and favor spontaneous closure.…”

Section: Introductionmentioning

confidence: 99%

Factors Predictive of Recurrence and Mortality after Surgical Repair of Enterocutaneous Fistula

Martínez

Luque-de-León

Ballinas-Oseguera

et al. 2012

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Many enterocutaneous fistulas (ECF) require operative treatment. Despite recent advances, rates of recurrence have not changed substantially. This study aims to determine factors associated with recurrence and mortality in patients submitted to surgical repair of ECF. Consecutive patients submitted to surgical repair of ECF during a 5-year period were studied. Several patient, disease, and operative variables were assessed as factors related to recurrence and mortality through univariate and multivariate analysis. There were 35 male and 36 female patients. Median age was 52 years (range, 17-81). ECF recurred in 22 patients (31%), 18 of them (82%) eventually closed with medical and/or surgical treatment. Univariate analyses disclosed noncolonic ECF origin (p = 0.04), high output (p = 0.001), and nonresective surgical options (p = 0.02) as risk factors for recurrence; the latter two remained significant after multivariate analyses. A total of 14 patients died (20%). Univariate analyses revealed risk factors for mortality at diagnosis or referral including malnutrition (p = 0.03), sepsis (p = 0.004), fluid and electrolyte imbalance (p = 0.001), and serum albumin <3 g/dl (p = 0.02). Other significant variables were interval from last abdominal operation to ECF operative treatment ≤20 weeks (p = 0.03), preoperative serum albumin <3 g/dl (p = 0.001), and age ≥55 years (p = 0.03); the latter two remained significant after multivariate analyses. Interestingly, recurrence after surgical treatment was not associated with mortality (p = 0.75). Among several studied variables, recurrence was only independently associated with high output and type of surgical treatment (operations not involving resection of ECF). Interestingly, once ECF recurred its management was as successful as non-recurrent fistulas in our series. Mortality was associated to previously-reported bad prognostic factors at diagnosis or referral.

show abstract

Treatment of High‐output Enterocutaneous Fistulas with a Vacuum‐compaction Device. A Ten‐year Experience

Abstract: The vacuum-compaction device proved effective for reducing fistula output in 89 of 91 patients (97.8%).

Cited by 60 publications

References 33 publications

Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery

Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery

Perioperative morbidity of radical cystectomy: A review

Factors Predictive of Recurrence and Mortality after Surgical Repair of Enterocutaneous Fistula

Contact Info

Product

Resources

About