Enteric fistulas encountered on a gynecologic oncology service from 1969 through 1980

In the 12 year period from 1969 to 1980, 56 patients with a total of 68 enteric fistulas were seen at the Gynecology Service of the Memorial Sloan-Kettering Cancer Center. Prior therapy was common, with 98 per cent of the patients having had previous surgical treatment and 88 per cent of the patients had had prior surgical treatment and radiation therapy. Management consisted of three phases: stabilization, definition and surgical therapy. Of the surgically treated patients, 89 per cent had successful fistula closure. Although TPN as a primary therapy was unsuccessful, adequate nutrition was essential in the management of these patients. In our series, surgical care was the final step in successful management. Of the possible types of operation, those providing total exclusion of the fistula from the intestinal stream proved to be most effective.