复杂肠外瘘的替代手术治疗

Alternative surgical treatment for complex enterocutaneous fistula.

作者信息

Schirmer C C, Gurski R R, Gugel F L, Lazzaron A R, Brentano L, Kruel C D

机构信息

Hospital de Clínicas de Porto Alegre, Departamento de Cirurgia da Faculdade de medicina da UFRGS, Brasil.

出版信息

Int Surg. 1999 Jan-Mar;84(1):29-34.

PMID:10421014

Abstract

A retrospective analysis on the clinical-surgical handling of patients with enterocutaneous fistula (ECF) was performed, where an alternative surgical technique was discussed: intestinal bypass. Fistula with draining over 500 ml/24 h, which were present in 13 patients, were classified as high debit. We defined as complex, the fistula with multiple orifices, high defect of the abdominal wall or through the mesh. The population studied consisted of 25 patients, 11 male, in a total of 34 ECF and mean age of 41.9 years. At clinical treatment with TPN for high debit ECF, 2 patients (16.6%) were cured, another 2 died and 8 (66.8%) needed surgical treatment. The surgery cured 7 patients (77.7%) with high debit ECF but 2 (22.3%) died. In the patients with low debit ECF, TPN cured 2 patients (40%) but failed in another 3 (60%). All patients with low debit ECF resolved with surgical treatment.

摘要

对肠皮肤瘘（ECF）患者的临床手术处理进行了回顾性分析，讨论了一种替代手术技术：肠旁路术。13例每日引流量超过500 ml/24 h的瘘被归类为高流量瘘。我们将具有多个开口、腹壁高度缺损或通过网片的瘘定义为复杂性瘘。研究人群包括25例患者，其中男性11例，共有34个ECF，平均年龄41.9岁。对于高流量ECF患者采用全胃肠外营养（TPN）进行临床治疗时，2例（16.6%）治愈，另外2例死亡，8例（66.8%）需要手术治疗。手术治愈了7例（77.7%）高流量ECF患者，但2例（22.3%）死亡。在低流量ECF患者中，TPN治愈了2例（40%），但另外3例（60%）治疗失败。所有低流量ECF患者均通过手术治疗得到治愈。