Conservative treatment of the digestive fistulas: personal experience

The authors, thanks to experience obtained in an Unit for the treatment of digestive fistulas, discuss the possibility of a conservative treatment for the anastomotic fistulas. From 2000 to 2003 were treated thirty-five patients with post-anastomotic gastroenteric fistulas marked according to their...

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Veröffentlicht in:Annali italiani di chirurgia 2005-11, Vol.76 (6), p.523-527
Hauptverfasser: Castriconi, Maurizio, Romagnuolo, Giuseppe, Giuliano, Maria Elena, Bartone, Giovanni, Chianese, Francesco, Maglio, Mauro Natale Domenico, Molino, Carlo, Festa, Patrizio, Zito, Enzo Saverio, De Sena, Guido
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Sprache:ita
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Zusammenfassung:The authors, thanks to experience obtained in an Unit for the treatment of digestive fistulas, discuss the possibility of a conservative treatment for the anastomotic fistulas. From 2000 to 2003 were treated thirty-five patients with post-anastomotic gastroenteric fistulas marked according to their localization, way end output (51.5% high, 42.8% moderate and 5.7% low). The treatment is based on an aspiration system, sometimes integrated with an irrigation system. A semi-permeable barrier was created over the fistula by vacuum packing a synthetic, hydrophobic, polymer covered with a self-adherent surgical sheet. This system create a vacuum chamber equipped with a subathmospheric pressures between 262.2 and 337.5 mmHg (350-450 mmbar), integrated with a continuous irrigation using antibiotic solutions or 3% lactic acid. The AA. obtained the resolution in 30 patients (85.7%), 3 patients needs the surgery (8.6%), 2 died, one for sepsis and the other one for malnutrition. The mean time for the closure was 45 days (from 20 to 90). A part of digestive external fistulas goes to spontaneous resolution so comes the idea that the creation of particular condition is the basis of their closure.
ISSN:0003-469X