Singh B, Haffejee A A, Allopi L, Moodley J
Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa.
Int Surg. 2009 Jul-Sep;94(3):262-8.
The outcome of surgery undertaken to repair high-output small bowel enterocutaneous fistula (SBECF) using the same technique was evaluated. Of a total of 282 patients with a high-output SBECF (daily fistula output > 500 ml), 183 patients were managed conservatively; in this group, a spontaneous closure rate of 81.4% (n = 149) and a mortality rate of 18.6% (n = 34) was noted. Ninety-nine patients (35.1%) underwent definitive surgical treatment. In all patients, after resection of the fistula, the entire small bowel was stented. Six patients (6%) died in the postoperative period. No complications developed as a result of intestinal stenting. Including the patients treated successfully for postoperative persistence of fistula, surgical repair was successful in 93 patients (93.9%). No patients returned with refistulization or small bowel obstruction within 6 months of surgery. We believe that routine intraluminal stenting should be an integral component of the surgical technique for the repair of SBECF.
评估了采用相同技术修复高流量小肠肠皮肤瘘（SBECF）的手术结果。在总共282例高流量SBECF（每日瘘液输出量>500 ml）患者中，183例患者接受了保守治疗；在该组中，观察到自发闭合率为81.4%（n = 149），死亡率为18.6%（n = 34）。99例患者（35.1%）接受了确定性手术治疗。所有患者在切除瘘管后，整个小肠都进行了支架置入。6例患者（6%）在术后死亡。未因肠道支架置入而出现并发症。包括术后瘘管持续存在但治疗成功的患者，手术修复成功93例（93.9%）。术后6个月内无患者因复发瘘管或小肠梗阻而返回。我们认为，常规腔内支架置入应成为SBECF修复手术技术的一个组成部分。
