Management of postoperative enterocutaneous fistulas: the roles of parenteral nutrition and surgery. 1982

A Sitges-Serra, and E Jaurrieta, and A Sitges-Creus

A series of 75 patients with 87 postoperative enterocutaneous fistulas (PEF) is reported. All received parenteral nutrition after the diagnosis of PEF was made. There were 16 deaths (21.3 per cent) and 62 fistulas (71.2 per cent) closed spontaneously. A classification of PEF is proposed according to the results obtained. The therapeutic approach cannot be uniform in all types of PEF. We feel that parenteral nutrition has substantially improved the prognosis of fistulous patients by increasing the rate of spontaneous closure and improving the nutritional status of patients needing repeated operations. Comparison between series of patients to establish the usefulness of parenteral nutrition is bound to yield inconclusive data due to marked differences in patient populations. We suggest that proper information be obtained by studying series of homogeneous patients, namely those who develop oesophageal, gastric or intestinal fistulas after surgery.

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
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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