Method for Establishing Continuous Reinfusion of Succus Entericus in Complex High-output Fistula

Area of Science:

• Gastroenterology
• Surgical Innovation
• Patient Management

Background:

• Complex high-output fistulas (HOF) present significant challenges in fluid and nutritional management.
• Loss of succus entericus contributes to malnutrition and electrolyte imbalances in HOF patients.
• Existing methods for managing HOF often have limitations in providing adequate nutritional support.

Purpose of the Study:

• To establish a minimally invasive technique for continuous reinfusion of succus entericus and enteral nutrition (EN) in complex HOF.
• To evaluate the efficacy of percutaneous puncture and catheterization for HOF management.
• To assess the impact of this technique on fistula healing and patient recovery.

Main Methods:

• A percutaneous puncture and catheterization technique was employed to establish continuous reinfusion of succus entericus and EN.
• The study included 21 patients diagnosed with complex HOF between May 2010 and June 2018.
• Data on fistula closure, need for surgery, and overall patient outcomes were collected.

Main Results:

• The percutaneous technique successfully established continuous reinfusion of succus entericus and EN in all 21 patients.
• Six patients (28.6%) achieved complete fistula closure with this method alone.
• Fifteen patients (71.4%) were cured after subsequent definitive surgical intervention, indicating improved surgical outcomes.
• The method effectively prevented succus entericus loss and facilitated EN delivery.

Conclusions:

• Percutaneous puncture and catheterization is a valuable and effective method for managing complex HOF.
• This technique overcomes barriers to enteral nutrition (EN) in HOF patients by preventing fluid loss.
• It serves as a crucial step in the management of high-output fistulas, improving healing rates and patient outcomes.