Ochsner J. 2013;13(4):507-11.
The etiology of enterocutaneous fistula predicts outcome.
The Ochsner journal
Meredith Holley Redden, Philip Ramsay, Tim Humphries, George M Fuhrman
Affiliations
Affiliations
- Department of Surgery, Atlanta Medical Center, Atlanta, GA.
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA.
PMID: 24357998
PMCID: PMC3865828
Abstract
BACKGROUND: The management of enterocutaneous fistula (ECF) provides a supreme challenge for the general surgeon.
METHODS: We conducted a retrospective review of all cases of patients with ECF referred to the surgical service from July 2007 to June 2011 to achieve a better understanding of the factors that predict a successful outcome.
RESULTS: A total of 35 patients were evaluated and managed in a systematic fashion that focused on treatment of abdominal sepsis, control of fistula output and wound management, nutritional optimization, and operative intervention when necessary. Age, gender, preoperative laboratory values, etiology of ECF, and prior abdominal surgery for ECF were reviewed and compared. Fisher exact test was used to compare patients who achieved a good outcome (n=23) to those with a poor outcome (n=12) to determine factors that might predict their ultimate result. Two factors that predicted poor outcome were the presence of abdominal malignancy (P=0.01) and ECFs that occurred in trauma patients with an open abdomen (P=0.03).
CONCLUSION: The etiology of ECF proved to be a more reliable predictor of outcome than clinical indicators.
Keywords: Intestinal fistula; parenteral nutrition—total; postoperative complications
References
- Ann Plast Surg. 2006 Dec;57(6):621-5 - PubMed
- Arch Surg. 2009 Jun;144(6):500-5 - PubMed
- J Gastrointest Surg. 2006 Mar;10(3):455-64 - PubMed
- J Palliat Med. 2011 Jul;14(7):822-8 - PubMed
- Br J Surg. 2006 Sep;93(9):1045-55 - PubMed
- Jpn J Clin Oncol. 2010 Aug;40(8):739-45 - PubMed
- World J Surg. 2008 Mar;32(3):430-5 - PubMed
- World J Surg. 2008 Mar;32(3):445-53 - PubMed
- Br J Surg. 2004 Dec;91(12):1646-51 - PubMed
- AJR Am J Roentgenol. 1996 Jul;167(1):33-8 - PubMed
- Clin Colon Rectal Surg. 2010 Sep;23(3):161-8 - PubMed
- Gut. 2001 Dec;49 Suppl 4:iv22-31 - PubMed
- J Wound Ostomy Continence Nurs. 2010 Mar-Apr;37(2):173-84 - PubMed
- World J Surg. 1999 Jun;23(6):570-6 - PubMed
- Dig Dis. 2003;21(3):198-213 - PubMed
- AJR Am J Roentgenol. 1982 Apr;138(4):615-9 - PubMed
- Surg Clin North Am. 1996 Oct;76(5):1095-109 - PubMed
- World J Surg. 1983 Jul;7(4):446-50 - PubMed
- Am Surg. 2010 Jun;76(6):637-9 - PubMed
- Digestion. 1999;60 Suppl 2:53-6 - PubMed
- Hepatogastroenterology. 2002 Jul-Aug;49(46):1010-2 - PubMed
- Ann Surg Oncol. 2001 Sep;8(8):632-7 - PubMed
- Surgery. 2006 Oct;140(4):570-6; discussion 576-8 - PubMed
- Ann Surg. 2004 Nov;240(5):825-31 - PubMed
- Br J Surg. 1990 Jan;77(1):97-100 - PubMed
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