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Enterocutaneous fistula: Update in 2026
Clément Pastier1, Maxime K Collard1, Alexandre Challine1
1Sorbonne Université, Service de chirurgie digestive, AP-HP, Hôpital Saint-Antoine, 75012 Paris, France.
Journal of Visceral Surgery
|April 7, 2026
Summary
Enterocutaneous fistulas (ECF) require multidisciplinary management, including nutritional support and surgical planning. Early curative surgery shows promise in selected patients, improving outcomes and reducing recurrence.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Critical Care Medicine
Background:
- Enterocutaneous fistulas (ECF) are complex gastrointestinal conditions.
- Management necessitates a multidisciplinary approach addressing sepsis, fluid balance, and nutrition.
- Skin prosthesis fitting presents challenges requiring specialized nursing care.
Purpose of the Study:
- To outline current management strategies for enterocutaneous fistulas.
- To evaluate the role of nutritional optimization and surgical intervention.
- To identify factors influencing successful ECF treatment outcomes.
Main Methods:
- Comprehensive review of ECF management principles.
- Analysis of nutritional support modalities (parenteral, enteral, oral).
- Evaluation of surgical techniques and outcomes for early vs. delayed intervention.
Main Results:
- Nutritional support recommendations: 25-35 kcal/kg/day and 1.5-2.5g/kg/day protein.
- Chyme re-instillation aids intestinal stimulation and prepares for continuity restoration.
- Early curative surgery (<4 months) is feasible in selected patients with an 80% success rate.
- Key factors for success include center expertise, patient optimization, and selection.
Conclusions:
- ECF management is complex, requiring integrated care.
- Nutritional strategies, including chyme re-instillation, are crucial.
- Early surgical intervention can be successful in select ECF cases.
- Optimizing patient selection and leveraging center expertise are vital for favorable outcomes.
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