Biomaterial Database

Surgery for high-output small bowel enterocutaneous fistula: a 30-year experience. 2009

B Singh, and A A Haffejee, and L Allopi, and J Moodley

Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa. singhb3@ukzn.ac.za

The outcome of surgery undertaken to repair high-output small bowel enterocutaneous fistula (SBECF) using the same technique was evaluated. Of a total of 282 patients with a high-output SBECF (daily fistula output > 500 ml), 183 patients were managed conservatively; in this group, a spontaneous closure rate of 81.4% (n = 149) and a mortality rate of 18.6% (n = 34) was noted. Ninety-nine patients (35.1%) underwent definitive surgical treatment. In all patients, after resection of the fistula, the entire small bowel was stented. Six patients (6%) died in the postoperative period. No complications developed as a result of intestinal stenting. Including the patients treated successfully for postoperative persistence of fistula, surgical repair was successful in 93 patients (93.9%). No patients returned with refistulization or small bowel obstruction within 6 months of surgery. We believe that routine intraluminal stenting should be an integral component of the surgical technique for the repair of SBECF.

UI	MeSH Term	Description	Entries
D007412	Intestinal Fistula	An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS).	Cholecystoduodenal Fistula,Colovesical Fistula,Enterocutaneous Fistula,Fistula, Cholecystoduodenal,Fistula, Colovesical,Fistula, Enterocutaneous,Fistula, Intestinal
D007421	Intestine, Small	The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM.	Small Intestine,Intestines, Small,Small Intestines
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D015607	Stents	Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.	Stent
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes