Clinical Treatment Results And Analysis Of25Cases With Postoperative Enterocutaneous Fistulae

Objective:We studied the etiology, treatment, and outcome of enterocutaneous fistulas after abdominal operation in25patients, to summarize and evaluate current practice and experience on clinical outcomes.Patients and Methods:We reviewed all cases of gastrointestinal-cutaneous fistula from2012to2013in Qilu Hospital of Shandong University. Twenty-five hospitalized patients with confirmed diagnosis of enterocutaneous fistula after abdominal operation were chosen; patients with irritable bowel disease and anorectal fistulas were excluded. Then the clinical data of25patients were retrospectively analyzed including gender, age, primary disease, clinical manifestations, selection of treatment methods, used time, hospitalization days, mortality and treatment effect.Results:Of the25patients in the study,8male17female, aged0～86, mainly young men. Fistula was found in2-13day after surgery with9～189hospitalization days. The etiology of the fistula was gastrointestinal cancer in16patients, benign diseases in9.The origin of the fistula was the high small bowel in12patients, low small bowel in6, colon in7. Fifteen had a high output fistula,9had a low output fistula. Total parenteral nutrition was used in most patients to provide nutritional support. Nonoperative treatment was used in all patients. Among the25cases,16patients received conservative treatment and9underwent surgical operation. For the16cases receiving conservative measures,14cases were cured, in which of4with successfully EDS, and2cases died. For the9patients undergoing surgical therapy,8cases were cured, and1cases died. Of25patients,3(12%) died of fistula complications. The cause of death was MODS caused by persistence or recurrence of cancer in2patients and abdominal hemorrhage in1.Conclusion:Early diagnosis and early treatment should be advocated and implemented since it is closely correlated with improved prognosis. Conditions should be dealt with on an individual case by case basis. It is suggested that we must take some corresponding counter measures comprising of conservative therapy and surgical therapy in order to improve the clinical efficacy in treatment of intestinal external fistulas, reduce the mortality rate, shorten the course of treatment, and decrease the cost of treatment.