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Delayed reconstructive surgery for complex enterocutaneous fistulae
R L Conter1, L Roof, J J Roslyn
1Division of General Surgery, UCLA School of Medicine 90024.
The American Surgeon
|October 1, 1988
Summary
Delayed reconstructive surgery for complex enterocutaneous fistulae in critically ill patients achieved high success rates. This staged approach, deferring definitive surgery, offers a viable management strategy for challenging cases.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Complex enterocutaneous fistulae pose significant challenges in patient management.
- Delayed reconstruction is often considered for fistulae associated with critical illness or large defects.
Purpose of the Study:
- To evaluate the outcomes of delayed reconstructive surgery for complex enterocutaneous fistulae.
- To assess the efficacy and safety of a staged, multidisciplinary approach in seriously ill patients.
Main Methods:
- Retrospective analysis of 51 consecutive patients with complex enterocutaneous fistulae.
- Inclusion of patients undergoing delayed reconstructive surgery.
Main Results:
- Gastrointestinal continuity was successfully restored in 94% of patients.
- A low mortality rate of 4% was observed in this seriously ill cohort.
Conclusions:
- A staged, multidisciplinary approach with delayed definitive surgery is effective for complex enterocutaneous fistulae.
- This strategy is particularly beneficial for patients with multiple, recurrent fistulae, or large abdominal wall defects.