Rudin E P, Bogdanov A V, Koshelev A P, Kurilovich V K, Chernyshov V S
Khirurgiia (Mosk). 1991 May(5):56-60.
Experience in the treatment of external gastrointestinal fistulas in 1970-1988 consisted of 127 patients with 158 fistulas; 11 patients had a gastric fistula; 14, a duodenal fistula, 42, a fistula of the small intestine; 38, a fistula of the large intestine, and 22 patients had mixed fistulas. Operation for acute appendicitis was the main cause of fistula formation (20.3%). In undeveloped fistulas with considerable and uncontrolled loss of the intestinal contents, treatment consisted in early operation for vital indications for disconnection of the fistula, with preference given to complete bilateral disconnection. In developed fistulas most operations for their closure were carried out through an intraabdominal approach. Total mortality was 25.2%; in most of the fatal cases (90.6%) the fistulas were undeveloped.
1970年至1988年期间,治疗外胃肠瘘的经验涉及127例患者的158处瘘管;11例为胃瘘;14例为十二指肠瘘;42例为小肠瘘;38例为大肠瘘;22例为混合性瘘。急性阑尾炎手术是瘘管形成的主要原因(20.3%)。对于未成熟的瘘管,若肠道内容物大量且无法控制地流失,治疗方法是在出现危及生命的指征时尽早进行瘘管切断手术,优先选择完全双侧切断。对于已成熟的瘘管,大多数闭合手术是通过腹腔内途径进行的。总死亡率为25.2%;在大多数致命病例(90.6%)中,瘘管是未成熟的。