External intestinal fistulae following gynecological operations and their treatment
Gorfinkel', I.V.; Rekhen, D.G.; Chirkov, I.V.
Vestnik Khirurgii Imeni I. I. Grekova 159(3): 85-87
2000
ISSN/ISBN: 0042-4625 PMID: 10983351 Document Number: 524635
The authors share their experiences with treatment of 38 patients with external intestinal fistulas after operations on internal genitals. The patients were divided into three groups: patients with pyo-inflammatory diseases, patients with benign tumors and patients with malignant neoplasms. It is noted that preoperative diagnosis of involvement of the intestine in the process is rather difficult, instrumental methods of examination in patients with pyo-inflammatory diseases are poorly informative. In patients with malignant diseases of the uterus and uterine appendages the sigmoid colon should be examined in order to exclude the penetration of the tumor. Adhesive processes resulting from previous operations are considered to be a predisposing factor. Relaparotomies must be performed with the obligatory participation of the surgeon. Operation on the intestine should be performed before the intervention on the internal genitals. The unloading colostomy must be made in suturing the defect of the colon. The use of the method described allowed to save the life of 36 patients (lethality was 5.3%).