Di Saverio S, Tarasconi A, Walczak DA, Cirocchi R, Mandrioli M, Birindelli A, Tugnoli G, et al.
Langenbeck's archives of surgery. Date of publication 2016 Feb 1;volume 401(1):1-13.
1. Langenbecks Arch Surg. 2016 Feb;401(1):1-13. doi: 10.1007/s00423-015-1370-3. Epub
2016 Feb 11.
Classification, prevention and management of entero-atmospheric fistula: a
state-of-the-art review.
Di Saverio S(1), Tarasconi A(2), Walczak DA(3), Cirocchi R(4), Mandrioli M(5),
Birindelli A(5), Tugnoli G(5).
Author information:
(1)Emergency Surgery and Trauma Surgery Unit, Maggiore Hospital Regional
Emergency Surgery and Trauma Center, Bologna Local Health District, AUSL,
Bologna, Italy. salo75@inwind.it.
(2)Emergency Surgery Department, Maggiore Hospital of Parma, University of Parma,
Parma, Italy.
(3)Department of General Surgery, John Paul II Memorial Hospital, Belchatow,
Poland.
(4)General and Emergency Surgery Department, Terni Hospital, University of
Perugia, Perugia, Italy.
(5)Emergency Surgery and Trauma Surgery Unit, Maggiore Hospital Regional
Emergency Surgery and Trauma Center, Bologna Local Health District, AUSL,
Bologna, Italy.
BACKGROUND: Entero-atmospheric fistula (EAF) is an enteric fistula occurring in
the setting of an open abdomen, thus creating a communication between the GI
tract and the external atmosphere. Management and nursing of patients suffering
EAF carries several challenges, and prevention of EAF should be the first and
best treatment option.
PURPOSE: Here, we present a novel modified classification of EAF and review the
current state of the art in its prevention and management including nutritional
issues and feeding strategies. We also provide an overview on surgical management
principles, highlighting several surgical techniques for dealing with EAF that
have been reported in the literature throughout the years.
CONCLUSIONS: The treatment strategy for EAF should be multidisciplinary and
multifaceted. Surgical treatment is most often multistep and should be tailored
to the single patient, based on the type and characteristics of the EAF,
following its correct identification and classification. The specific experience
of surgeons and nursing staff in the management of EAF could be enhanced,
applying distinct simulation-based ex vivo training models.
DOI: 10.1007/s00423-015-1370-3
PMID: 26867939 [Indexed for MEDLINE]
