Allardyce D B
Am J Surg. 1983 May;145(5):593-5. doi: 10.1016/0002-9610(83)90099-5.
Fifty-two patients with fistulas that arose from the small intestine were encountered in the 6 year span between 1975 and 1981. The mortality rate in this group was 38 percent, the average hospital stay was 95 days, and 47 patients were receiving total parenteral nutrition for an average of 56 days. Intraabdominal sepsis and peritonitis forced early reoperation in eight patients in whom exteriorization of the fistula as an ileostomy and mucous fistula and reconstruction after a long interval, was a more successful means of management than were attempts at immediate resection and anastomosis. Nineteen of 44 patients (43 percent) had spontaneous closure while receiving parenteral nutrition without oral feeding. The average time span to spontaneous closure of the fistula was 25 days. Delayed reoperation was carried out after a long interval in patients without spontaneous closure. There was a high rate of success with resection of the fistula and primary anastomosis.
1975年至1981年的6年间，共收治了52例小肠瘘患者。该组患者的死亡率为38%，平均住院时间为95天，47例患者接受了平均56天的全胃肠外营养支持。腹腔内感染和腹膜炎迫使8例患者早期再次手术，将瘘管外置为回肠造口和黏液瘘，经过较长时间间隔后进行重建，这种处理方法比立即进行切除吻合术更为成功。44例患者中有19例（43%）在接受全胃肠外营养支持且未进行口饲时实现了瘘管自发闭合。瘘管自发闭合的平均时间为25天。未实现自发闭合的患者经过较长时间间隔后进行了延迟再次手术。瘘管切除并一期吻合的成功率很高。
