Management of enterocutaneous fistulas in UMAE Hospital de Especialidades Dr. Antonio Fraga Mouret La Raza hospital of specialties

Rossy M. Rebollar

doi:10.18203/2349-2902.isj20231961

Authors

Rossy M. Rebollar UMAE, Hospital de Especialidades Dr Antonio Fraga Mouret La Raza, México City, México

DOI:

https://doi.org/10.18203/2349-2902.isj20231961

Keywords:

Enterocutaneous fistulas, Initial, Definitive, Conservative, Surgical treatment, Cure, Recurrence, Chronicity

Abstract

Background: Describes the management of enterocutaneous fistulas in UMAE specialty hospital "Dr Antonio Fraga Mouret La Raza".

Methods: Descriptive, observational, retrospective and cross-sectional study, records were reviewed describing the management of patients with enterocutaneous fistulas, period from 01/01/2017 to 12/31/2021, each qualitative variable described in frequency and percentages, data processed by SPSS, quantitative variables described with measures of central tendency and dispersion.

Results: The 90 patients were included, 76.7% male and 23.3% female, median age 56 years. Anatomical location with greater frequency (42.2%) in ileum; 98.8% of the fistulas were surgical etiology, 100% operated by open procedure, 51.1% of the patients did not present comorbidities prior to the condition, 37.5% received definitive conservative management and 62.2% definitive surgical treatment, 36.7% presented definitive cure and 27.8% were recurrent, 35.6% presented chronicity.

Conclusions: Male sex was most affected, 58.9% received initial conservative management and 41.1% surgical treatment, so 37.5% received definitive conservative management and 62.2% definitive surgical management, of which 36.7% were cured compared to the 35.6% who cornified; which reflects that there is no high significance between cure and chronicity of patients treated with definitive management, either conservative or surgical, it is undoubtedly concluded that the most prevalent intrahospital treatment is definitive surgical.

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References

Osborn C, Fischer JE. How I do it: gastrointestinal cutaneous fistulas. J Gastrointest Surg. 2009;13(11):2068-73.

Schecter WP, Hirshberg A, Chang DS. Enteric fistulas: principles of management. J Am Coll Surg. 2009;209(4):484-91.

Evenson AR, Fischer JE. Current management of enterocutaneous fistula. J Gastrointest Surg. 2006;10(3):455-64.

Tapia Jurado J, Murguía Corral AA. Enterocutaneous fistulas. In: Tratado de cirugía general. 2nd ed. Mexico: Manual Moderno. 2008;729-36.

Clemente Gutiérrez U, Santes Jasso O, Morales Maza J. Enterocutaneous fistulas: updates on diagnosis and treatment. Rev Mex de Cirugía del Aparato Digestivo. 2017 Jul-Sep; 6(3):120-6.

Martínez Ordáz JL, Luque de León E, Suarez Moreno R, et al. Postoperative enterocutaneous fistulas. Gac Méd Méx 2003; 139 (2): 144-9.

Arenas-Márquez H, Anaya-Prado R, Hurtado H. Mexican consensus on the integral management of digestive tract fistulas. Cir Gen. 2000;22:287-29.

Fischer JE, Evenson AR. Gastrointestinal-cutaneous fistula. In: Fischer JE. Fischer's Mastery of Surgery. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2012;1564-74.

Tavares de la Paz LA, Andrade de la Garza, Sanchez Fernandez P. Open abdomen. Evolution in its management. Cir Ciruj. 2008;76:177-86.

Demetriades D, Salim A. Management of the open abdomen. Surg Clin North Am. 2014;94(1):131-53.

Tawadros PS, Simpson J, Fisher JE, Rotstein OD. Abdominal Abscess and Enteric Fistulae. In: Zinner MJ, Ashley SW. Maingot's Abdominal Operations. 12 th ed. Boston: Mc Graw-Hill. 2013;197-216.

Berry SM, Fischer JE. Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am. 1996;76(5):1009-18.

Joyce MR, Dietz DW. Management of complex gastrointestinal fistula. Curr Probl Surg. 2009;46(5):384-430.

Reber HA, Roberts C, Way LW. Management of external gastrointestinal fistulas. Ann Surg. 1978;188(4):460-7.

Haffejee AA. Surgical management of high output enterocutaneous fistulae: a 24-year experience. Curr Opin Clin Nutr Metab Care. 2004;7(3):309-16.

Berry SM, Fischer JE. Enterocutaneous fistulas. Curr Probl Surg. 1994;31(6):469-566.

Fischer JE, Evenson AR. Chapter 126: Gastrointestinal-cutaneous fistulae. In: Mastery of Surgery, Fischer JE (Ed), Lippincott Williams and Wilkins 2007;1401-7.

Visschers RG, Van Gemert WG, Winkens B, Soeters PB, Olde Damink SW. Guided treatment improves outcome of patients with enterocutaneous fistulas. World J Surg. 2012;36(10):2341-8.

General Health Law. New law published in the Official Gazette of the Federation. Cámara de Diputados del H. Congreso de la Unión. Mexico. 1984. Available at: http://www.diputados.gob. mx/LeyesBiblio/pdf_mov/Ley_General_de_Salud.pdf. Accessed on 25 April, 2023.

Regulation of the General Health Law on Health Research. New regulation published in the Diario Oficial de la Federación. Mexico. 2014. Available at: http://www.diputados.gob.mx/LeyesBiblio/regley/Reg_LGS_MIS.pdf. Accessed on 25 April, 2023.

Ministry of Health. Norma Oficial Mexicana NOM-012-SSA3-2012, que establece los criterios para la ejecución de proyectos de investigación para la salud en seres humanos. Mexico. 2009. Available at: http://dof.gob.mx/nota_detalle.php?codigo=5284148&fecha=04/01/2013#:~:text=NORMA%20Oficial%20Mexican%20NOM%202D012,la%20health%20in%20human%20beings%20humans. Accessed on 25 April, 2023.

Gribovskaja-Rupp I, Melton GB. Enterocutaneous Fistula: Proven Strategies and Updates. Clin Colon Rectal Surg. 2016;29(2):130-7.

Soeters PB, Ebeid AM, Fischer JE. Review of 404 patients with gastrointestinal fistulas. Impact of parenteral nutrition. Ann Surg. 1979;190(2):189-202.

Martinez JL, Luque-de-Leon E, Mier J, Blanco-Benavides R, Robledo F. Systematic management of postoperative enterocutaneous fistulas: factors related to outcomes. World J Surg. 2008;32(3):436-43.