Ross Howard
Colon and Rectal Surgery, Riverview Medical Center, Red Bank, New Jersey.
Clin Colon Rectal Surg. 2010 Sep;23(3):190-4. doi: 10.1055/s-0030-1262987.
The management of the patient with an enterocutaneous fistula is complex and requires coordinated care on many fronts for successful elimination. With optimal nonoperative management a fistula may heal spontaneously, the majority within the first 4 weeks after development. Definitive surgical treatment is best achieved with resection of the bowel containing the fistula and anastomosis of healthy normal bowel. The timing of definitive surgery appears to be optimal months after development, if tolerated. Death rates are low after surgery and patients who experience the recurrence of a fistula after initial attempt at closure can ultimately still be cured.
肠皮肤瘘患者的管理很复杂，需要多方面的协调护理才能成功消除瘘管。通过最佳的非手术管理，瘘管可能会自发愈合，大多数在形成后的前4周内愈合。通过切除含有瘘管的肠段并将健康的正常肠段进行吻合，可实现最佳的确定性手术治疗。如果患者能够耐受，确定性手术的时机似乎在瘘管形成后的数月最为合适。手术后死亡率较低，初次尝试闭合瘘管后复发的患者最终仍可治愈。
