Sailer M, Bussen D, Thiede A
Chirurgische Klinik und Poliklinik der Universität Würzburg.
Chirurg. 2004 May;75(5):484-91. doi: 10.1007/s00104-004-0877-x.
Treatment of anastomotic fistulas generally implies an individualized concept. The origin of these complications is multifactorial and comprises such factors as primary operation, oncologic situation, comorbidity, and patient age as well as fistula-specific considerations such as anatomic localization, secretion volume, etc. In the case of high-output fistulas, it is of great importance to counteract fluid and electrolyte imbalances. Furthermore, skin maceration due to aggressive secretion needs to be averted. Therapeutic options include operative and endoscopic interventions. Octreotide plays a role in high-output and pancreatic fistulas. Any underlying ailment (e.g., Crohn's disease) requires an optimal disease-specific treatment which characterizes an interdisciplinary approach to such fistulas. The following article discusses general and site-specific considerations in the diagnosis and treatment of anastomotic fistulas.
吻合口瘘的治疗通常需要个体化理念。这些并发症的发生是多因素的，包括初次手术、肿瘤情况、合并症、患者年龄等因素，以及瘘管特异性因素，如解剖定位、分泌量等。对于高流量瘘，纠正液体和电解质失衡非常重要。此外，还需避免因大量分泌物导致的皮肤浸渍。治疗选择包括手术和内镜干预。奥曲肽在高流量瘘和胰瘘的治疗中发挥作用。任何潜在疾病（如克罗恩病）都需要进行最佳的针对该疾病的治疗，这体现了对此类瘘管采用多学科方法的特点。以下文章讨论了吻合口瘘诊断和治疗中的一般及特定部位的注意事项。
