Surgical and medical treatment outcome of enterocutaneus fistulas
Bada-Yllán, O.; Téllez-Avila, F.él.I.; Takahashi-Monroy, T.; Hoyos-Tello, C.M.ía.; Zárate, X.; García-Osogobio, S.
Acta Gastroenterologica Latinoamericana 39(4): 273-277
2009
ISSN/ISBN: 0300-9033 PMID: 20178257 Document Number: 637551
Enterocutaneous fistulas are an important complication of gastrointestinal surgery. Most of the cases (75% to 85%) are secondary to postoperative complications and are related to a high morbi-mortality rate, mainly sepsis, malnutrition and fluid and electrolyte imbalance. The aim of this study is to describe the main causes of enterocutaneous fistulas and morbi-mortality associated to treatment in the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Retrospective, observational and longitudinal study. Clinical records of patients with enterocutaneous fistula from January 1999 to December 2003 were reviewed. 51 patients were identified; median age was 45 years (interval 20 to 79 years). Fistula resulted from surgery in 49 cases (96%). A combined therapy of total parenteral nutrition and low residue diet were used in 28 patients (55%). Surgery was performed as definitive treatment in 29 patients (57%). Indications for surgery were: failure to medical treatment in 25 patients (59%) and a persistent high output in 4 (8%). The median of postoperative hospitalization was 11 days (interval 3 to 96 days) and the median of lenght of stay was 30 days (interval 40 to 130 days). There was no mortality. Enterocutaneous fistulas require long time of hospitalization. More than 50% of patients need surgery as final treatment.