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The staged management of complex entero-urinary fistulae
D C Shackley1, C J Brew, A A Bryden
1Department of Urological Surgery, and Intestinal Failure Unit, Hope Hospital, Salford Royal Hospitals Trust, Salford, UK. dshackley@picr.man.ac.uk
BJU International
|November 9, 2000
Summary
A staged, multidisciplinary approach successfully managed complex entero-urinary fistulae in ten patients. This method, involving delayed reconstruction, achieved positive outcomes and functional restoration or diversion.
Area of Science:
- Gastroenterology
- Urology
- Surgical Management
Background:
- Complex entero-urinary fistulae present a significant clinical challenge.
- Previous treatments often fail, necessitating specialized care.
Purpose of the Study:
- To present the outcomes of a staged management protocol for complex entero-urinary fistulae.
- To evaluate a multidisciplinary approach involving delayed reconstruction.
Main Methods:
- Review of ten patients with complex entero-urinary fistulae referred to a national intestinal failure unit.
- A three-stage treatment: acute (defunctioning, drainage, sepsis control), recovery (nutrition, support, planning), and reconstructive (surgical repair).
- Joint surgical intervention by urological and gastrointestinal specialists.
Main Results:
- Successful treatment of fistulae in all ten patients.
- Functional restoration in four patients and diversion in six.
- Mean reconstruction time of 5 months; no postoperative deaths.
Conclusions:
- A staged, multidisciplinary approach with delayed reconstruction is effective for complex entero-urinary fistulae.
- This strategy leads to successful outcomes and functional recovery or diversion.