Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.
Digestive Endoscopy Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.
Surg Endosc. 2024 Nov;38(11):6956-6962. doi: 10.1007/s00464-024-11281-0. Epub 2024 Oct 6.
The Endoscopic Purse-string Suture (EPSS) technique has gained attention for its potential in closing large defects following gastrointestinal procedures. However, its application in fistula closure is not as widely reported. This study aims to evaluate the safety and efficacy of EPSS and naso-jejunal tube feeding in the closure of duodenal cutaneous fistulas and gastric cutaneous fistulas.
This single-center retrospective study, conducted from September 2020 to September 2023 at Tongji University in Shanghai, China, examined the outcomes of EPPS and nasojejunal feeding for patients with gastric and duodenal cutaneous fistulas (n = 10). Demographic data, fistula characteristics, procedure technique and outcomes were evaluated.
In this study, the average size of a fistula opening was 7.9 ± 4.6 mm. The operations took an average of 25.8 ± 5.6 min. Patients typically needed naso-jejunal tube feeding for a median of 14.0 days, with an interquartile range (IQR) of 7.7-19.0 days. The median duration of hospital stay post-operation was 16.5 days, with an IQR of 7.0-25.0 days. Nine patients were successful in their initial fistula closure using the EPSS technique. The other patient underwent a second EPSS and, ultimately, all patients experienced complete healing and fully recovered. There were no major adverse events reported.
EPSS and naso-jejunal tube feeding are a safe and effective treatment option for duodenal and gastric cutaneous fistulas. Larger, prospective studies are needed to validate these findings and establish the long-term safety and efficacy of this approach.
内镜荷包缝合（EPSS）技术在胃肠手术后闭合大缺损方面引起了关注。然而，其在瘘口闭合中的应用报道并不广泛。本研究旨在评估 EPSS 和鼻空肠管喂养在十二指肠皮肤瘘和胃皮肤瘘闭合中的安全性和有效性。
这是一项单中心回顾性研究，于 2020 年 9 月至 2023 年 9 月在上海同济大学进行，研究了 EPPS 和鼻空肠喂养在胃和十二指肠皮肤瘘患者中的应用（n=10）。评估了人口统计学数据、瘘口特征、手术技术和结果。
本研究中，瘘口开口的平均大小为 7.9±4.6mm。手术平均需要 25.8±5.6 分钟。患者通常需要鼻空肠管喂养 14.0 天，中位数为 7.7-19.0 天。术后住院时间中位数为 16.5 天，四分位间距为 7.0-25.0 天。9 例患者采用 EPSS 技术成功地初次闭合瘘口。另一位患者进行了第二次 EPSS，最终所有患者均完全愈合并完全康复。没有报告重大不良事件。
EPSS 和鼻空肠管喂养是治疗十二指肠和胃皮肤瘘的安全有效的方法。需要更大规模的前瞻性研究来验证这些发现，并确定该方法的长期安全性和有效性。
