Lifshitz S, Johnson R, Roberts J A, Buchsbaum H J
Surg Gynecol Obstet. 1981 May;152(5):630-2.
Intestinal fistulas and obstruction are the most common and most serious complication of pelvic exenteration for gynecologic cancer. In a series of 58 patients, early intestinal fistulas developed in seven and late fistulas in 13 of the patients. Early fistulas are more commonly secondary to surgical trauma or technical errors and were noted to occur more frequently in patients who had previously undergone irradiation. Late fistulas are usually associated with intestinal obstruction and with a high incidence of recurrent malignant growth. The management of choice for intestinal fistulas following pelvic exenteration appears to be prompt surgical intervention with bypass procedures in preference to intestinal resections. Although several technical modifications have been applied to the exenterative operation with a trend toward a decrease in early obstruction and fistula formation rate, additional technical efforts will be necessary if these problems are to be solved.
肠瘘和肠梗阻是妇科癌症盆腔脏器清除术最常见、最严重的并发症。在一组58例患者中，7例出现早期肠瘘，13例出现晚期肠瘘。早期肠瘘更常见于手术创伤或技术失误，且在既往接受过放疗的患者中发生率更高。晚期肠瘘通常与肠梗阻及恶性肿瘤复发的高发生率相关。盆腔脏器清除术后肠瘘的首选治疗方法似乎是迅速进行手术干预并采用旁路手术，而非肠切除术。尽管已对脏器清除术进行了多项技术改进，早期肠梗阻和肠瘘形成率有下降趋势，但要解决这些问题仍需进一步的技术努力。
