Leang YJ, Bell SW, Carne P, Chin M, Farmer C, Skinner S, Wale R, Warrier SK, et al.
ANZ journal of surgery. Date of publication 2018 Jan 1;volume 88(1-2):E30-E33.
1. ANZ J Surg. 2018 Jan;88(1-2):E30-E33. doi: 10.1111/ans.13686. Epub 2016 Jul 24.
Enterocutaneous fistula: analysis of clinical outcomes from a single Victorian
tertiary referral centre.
Leang YJ(1), Bell SW(1), Carne P(1), Chin M(1), Farmer C(1), Skinner S(1), Wale
R(1), Warrier SK(1).
Author information:
(1)Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria,
Australia.
BACKGROUND: Enterocutaneous fistulas (ECFs) are complex and can result in
significant morbidity and mortality. The study aimed to evaluate ECF outcomes in
a single tertiary hospital.
METHODS: A retrospective study of all patients treated with ECF between the
period of January 2009 and June 2014 was conducted. Baseline demographic data
assessed included the primary aetiology of the fistula, site of the fistula and
output of the fistula. Outcomes measures assessed included re-fistulation rate,
return to theatre, wound complications, fistula closure rate and death over the
study period.
RESULTS: A total of 16 patients with ECF were recorded within the study period.
Mean age of the patient cohort was 55.8 ± 11.8 years with a female predominance
(11 females, 5 males). Primary aetiology were Crohn's disease (31%), post
intra-abdominal surgery not related to bowel neoplasia (50%) and post
intra-abdominal surgery related to bowel neoplasia (19%). Majority of the
fistulas developed from the small bowel (75%) and had low output (63%). Operative
intervention was required in 81% of patients with an overall closure rate of
100%. Median operations required for successful closure was 1.15 operations. Mean
duration between index operation and curative operation was 8 ± 12.7 months.
CONCLUSION: Appropriate bundle of care (perioperative care, surgical timing and
surgical technique) can produce excellent results in patients with ECF.
© 2016 Royal Australasian College of Surgeons.
DOI: 10.1111/ans.13686
PMID: 27452814 [Indexed for MEDLINE]
