Two-Stage Treatment of Enterocutaneous Fistulas
Aim: to determine the most efficient treatment of enterocutaneous fistulas.Materials and methods. Eighty-eight patients with intestinal fistulas underwent a two-stage treatment, including: the first stage — multicomponent therapy, the second stage — reconstructive surgery. Enterocutaneous fistulas w...
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| Format: | Article |
| Language: | Russian |
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Gastro LLC
2023-11-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/788 |
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| author | V. Yu. Struchkov S. V. Berelavichus E. A. Akhtanin D. S. Gorin M. V. Dvukhzhilov A. A. Goev A. I. Burmistrov P. V. Markov A. G. Kriger |
| author_facet | V. Yu. Struchkov S. V. Berelavichus E. A. Akhtanin D. S. Gorin M. V. Dvukhzhilov A. A. Goev A. I. Burmistrov P. V. Markov A. G. Kriger |
| author_sort | V. Yu. Struchkov |
| collection | DOAJ |
| description | Aim: to determine the most efficient treatment of enterocutaneous fistulas.Materials and methods. Eighty-eight patients with intestinal fistulas underwent a two-stage treatment, including: the first stage — multicomponent therapy, the second stage — reconstructive surgery. Enterocutaneous fistulas were diagnosed in 61 patients, enteroatmospheric fistulas — in 26 patients, and combined fistula (enterocutaneous and enteroatmospheric) — in 1 patient.Results. All 88 patients underwent reconstructive surgery after the multicomponent therapy. Resection of the intestine with a fistula with the formation of an entero-entero anastomosis was performed in 72 (81.8 %) patients; marginal resection of the intestine with a fistula, followed by suturing of the defect — in 7 (8.0 %); resection of the intestine with fistulas in combination with excision and suturing of the fistula — in 5 (5.7 %); an operation aimed at disabling the fistula from the passage of intestinal contents — in 3 (3.4 %); resection of the intestine with a fistula in combination with fistula exclusion — in 1 (1.1 %) patient. Postoperative complications in the group of patients with enteroatmospheric fistulas occurred in 13 cases, in the group with enterocutaneous fistulas — in 25 patients. Three (3.4 %) patients with enterocutaneous fistulas died from complications unrelated to the underlying disease and surgical interventions.Conclusion. Two-stage treatment including multicomponent therapy (nutritional support, infection generalization control, local wound treatment) and reconstructive surgery allowed to reduce mortality rates to 3.4 %, which proves the effectiveness of this method. |
| format | Article |
| id | doaj-art-b849dbf7afc944d3a1566368133ac279 |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2023-11-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-b849dbf7afc944d3a1566368133ac2792025-02-10T16:14:38ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732023-11-01334586910.22416/1382-4376-2023-33-4-58-69559Two-Stage Treatment of Enterocutaneous FistulasV. Yu. Struchkov0S. V. Berelavichus1E. A. Akhtanin2D. S. Gorin3M. V. Dvukhzhilov4A. A. Goev5A. I. Burmistrov6P. V. Markov7A. G. Kriger8National Medical Research Center of Surgery named after A. VishnevskyMultidisciplinary Medical Center of the Central Bank of the Russian FederationNational Medical Research Center of Surgery named after A. VishnevskyNational Medical Research Center of Surgery named after A. VishnevskyNational Medical Research Center of Surgery named after A. VishnevskyNational Medical Research Center of Surgery named after A. VishnevskyNational Medical Research Center of Surgery named after A. VishnevskyNational Medical Research Center of Surgery named after A. VishnevskyRussian Scientific Center of Roentgenoradiology; Russian Medical Academy of Continuous Professional EducationAim: to determine the most efficient treatment of enterocutaneous fistulas.Materials and methods. Eighty-eight patients with intestinal fistulas underwent a two-stage treatment, including: the first stage — multicomponent therapy, the second stage — reconstructive surgery. Enterocutaneous fistulas were diagnosed in 61 patients, enteroatmospheric fistulas — in 26 patients, and combined fistula (enterocutaneous and enteroatmospheric) — in 1 patient.Results. All 88 patients underwent reconstructive surgery after the multicomponent therapy. Resection of the intestine with a fistula with the formation of an entero-entero anastomosis was performed in 72 (81.8 %) patients; marginal resection of the intestine with a fistula, followed by suturing of the defect — in 7 (8.0 %); resection of the intestine with fistulas in combination with excision and suturing of the fistula — in 5 (5.7 %); an operation aimed at disabling the fistula from the passage of intestinal contents — in 3 (3.4 %); resection of the intestine with a fistula in combination with fistula exclusion — in 1 (1.1 %) patient. Postoperative complications in the group of patients with enteroatmospheric fistulas occurred in 13 cases, in the group with enterocutaneous fistulas — in 25 patients. Three (3.4 %) patients with enterocutaneous fistulas died from complications unrelated to the underlying disease and surgical interventions.Conclusion. Two-stage treatment including multicomponent therapy (nutritional support, infection generalization control, local wound treatment) and reconstructive surgery allowed to reduce mortality rates to 3.4 %, which proves the effectiveness of this method.https://www.gastro-j.ru/jour/article/view/788enterocutaneous fistulaenteroatmospheric fistulatwo-stage treatmentnutritional supportnutritional deficiencysurgical treatment |
| spellingShingle | V. Yu. Struchkov S. V. Berelavichus E. A. Akhtanin D. S. Gorin M. V. Dvukhzhilov A. A. Goev A. I. Burmistrov P. V. Markov A. G. Kriger Two-Stage Treatment of Enterocutaneous Fistulas Российский журнал гастроэнтерологии, гепатологии, колопроктологии enterocutaneous fistula enteroatmospheric fistula two-stage treatment nutritional support nutritional deficiency surgical treatment |
| title | Two-Stage Treatment of Enterocutaneous Fistulas |
| title_full | Two-Stage Treatment of Enterocutaneous Fistulas |
| title_fullStr | Two-Stage Treatment of Enterocutaneous Fistulas |
| title_full_unstemmed | Two-Stage Treatment of Enterocutaneous Fistulas |
| title_short | Two-Stage Treatment of Enterocutaneous Fistulas |
| title_sort | two stage treatment of enterocutaneous fistulas |
| topic | enterocutaneous fistula enteroatmospheric fistula two-stage treatment nutritional support nutritional deficiency surgical treatment |
| url | https://www.gastro-j.ru/jour/article/view/788 |
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