COMPLEX TREATMENT OF ENTEROCUTANEOUS FISTULAS doc.struchkov@gmail.com

PE080

COMPLEX TREATMENT OF ENTEROCUTANEOUS FISTULAS

4

 

 

 

 

Russia

Oral or Poster

Enterocutaneous fistula (ECF) is an abnormal communication between the gastrointestinal tract and skin, with a myriad of etiologies and therapeutic options. Most often, ESF occurs as a complication of abdominal surgery. Management is influenced by etiology and specifics of the ECF, and patient-related factors. The aim of this study was to determine the most efficient treatment of enterocutaneous fistulas.

178 patients underwent a two-stage treatment, including: the first stage - multicomponent therapy; the second stage is reconstructive surgery. Enterocutaneous fistulas were diagnosed in 136 patients, enteroatmospheric fistulas (EAF) in 35 patients, and combined fistula (ECF and EAF) in 7 patient.

All 178 patients underwent reconstructive surgery after the multicomponent therapy. Small bowel resection with anastomosis was performed in 138 (77.5%) patients; marginal resection of ECF - 15 (8.4%); small bowel resection and marginal resection - 17 (9.6%); an operation aimed at disabling the fistula from the passage of intestinal contents - 8 (4.5%) patients. Postoperative complications in the group of patients with enteroatmospheric fistulas occurred in 22 patients; in the group with enterocutaneous fistulas in 42 patients. 7 (3.9%) patients with enterocutaneous fistulas are died.

Complex treatment, including: multicomponent therapy (nutritional support, sepsis control, wound treatment) and reconstructive surgery allowed to reduce mortality rates to 3.9%, which proves the effectiveness of this method.