Young Shamar, D'Souza Donna, Hunter David, Golzarian Jafar, Rosenberg Michael
1 Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455.
2 Department of Surgery, University of Minnesota, Minneapolis, MN.
AJR Am J Roentgenol. 2017 Jun;208(6):1373-1377. doi: 10.2214/AJR.16.17294. Epub 2017 Mar 16.
The objective of our study was to retrospectively review an institutional protocol that uses latex catheters for the treatment of enterocutaneous fistulas (ECFs) that are resistant to simple drainage.
Forty-six consecutive patients with ECFs that did not close with simple abscess drainage were treated with latex catheters. These patients' charts were retrospectively reviewed to determine treatment success rates and the relationship of treatment success to clinical characteristics.
ECFs in 26 of the 46 (56.5%) patients were treated successfully with latex catheters. On univariate analysis, the fistulas that originated from the stomach were statistically less likely to close (p = 0.03), whereas those originating from the small bowel were more likely to close (p = 0.01). The duration of treatment was significantly longer in patients for whom the treatment failed than in those who were successfully treated (p = 0.003). After a total treatment time of more than 116 days (odds ratio [OR], 9.8 [95% CI, 2.5-38.4]; p = 0.001) or latex catheter treatment time of more than 74 days (OR, 8.9 [95% CI, 2.2-35.0]; p = 0.002), the chance of ECF closure decreased significantly.
Treatment of ECFs that are resistant to simple abscess cavity drainage with a latex catheter is possible and decreases the need for surgery.
我们研究的目的是回顾一项机构方案，该方案使用乳胶导管治疗对单纯引流无效的肠皮肤瘘（ECF）。
46例经单纯脓肿引流未闭合的ECF患者接受乳胶导管治疗。对这些患者的病历进行回顾性分析，以确定治疗成功率以及治疗成功与临床特征之间的关系。
46例患者中有26例（56.5%）的ECF通过乳胶导管治疗成功。单因素分析显示，起源于胃的瘘管闭合的可能性在统计学上较小（p = 0.03），而起源于小肠的瘘管闭合的可能性较大（p = 0.01）。治疗失败的患者治疗时间明显长于治疗成功的患者（p = 0.003）。总治疗时间超过116天（优势比[OR]，9.8[95%可信区间，2.5 - 38.4]；p = 0.001）或乳胶导管治疗时间超过74天（OR，8.9[95%可信区间，2.2 - 35.0]；p = 0.002）后，ECF闭合的机会显著降低。
用乳胶导管治疗对单纯脓肿腔引流无效的ECF是可行的，并减少了手术需求。
