Torres-García A J, Argüello J M, Balibrea J L
II Dept. of Surgery, University Hospital of San Carlos, Madrid, Spain.
Scand J Gastroenterol Suppl. 1994;207:39-41. doi: 10.3109/00365529409104193.
Gastrointestinal fistulas are a serious complication of gastrointestinal tract surgery: they are often accompanied by high levels of morbidity and mortality. Among other things, some fistula characteristics (anatomical site, type of tract, time elapsed to fistula appearance and volume of output) are being considered as of great importance. New therapeutic approaches such as somatostatin are nowadays being tested in order to clarify the benefits of its use.
A multi-centre, randomized, controlled and prospective trial was carried out (n = 40, March-December, 1988) to evaluate the effectiveness of total parenteral nutrition (TPN) versus TPN + somatostatin in the conservative management of postoperative gastrointestinal fistulas. Since January 1989, wider inclusion criteria have been followed, and all patients (n = 63) who have fulfilled inclusion criteria have been admitted to TPN plus somatostatin treatment.
Closure time of fistulas in patients receiving TPN + somatostatin was significantly shorter (13.86 +/- 1.84 versus 20.4 +/- 2.89 days) than in those receiving TPN alone. In the second phase of the study, more time was needed to obtain complete closure of fistulas (15.8 days).
Somatostatin is a useful therapeutic complement in the management of postoperative gastrointestinal fistulas, since it accelerates their spontaneous closure.
胃肠道瘘是胃肠道手术的严重并发症，常伴有高发病率和死亡率。其中，一些瘘的特征（解剖部位、瘘管类型、出现瘘的时间及引流量）被认为非常重要。如今正在测试诸如生长抑素等新的治疗方法，以明确其使用的益处。
开展了一项多中心、随机、对照的前瞻性试验（n = 40，1988年3月至12月），以评估全胃肠外营养（TPN）与TPN + 生长抑素在术后胃肠道瘘保守治疗中的有效性。自1989年1月起，采用了更宽泛的纳入标准，所有符合纳入标准的患者（n = 63）均接受TPN加生长抑素治疗。
接受TPN + 生长抑素治疗的患者瘘管闭合时间（13.86 ± 1.84天，而单独接受TPN治疗的患者为20.4 ± 2.89天）明显短于单独接受TPN治疗的患者。在研究的第二阶段，实现瘘管完全闭合需要更多时间（15.8天）。
生长抑素在术后胃肠道瘘的治疗中是一种有用的治疗补充药物，因为它能加速瘘管的自然闭合。
