Spiliotis J, Briand D, Gouttebel M C, Astre C, Louer B, Saint-Aubert B, Kalfarentzos F, Androulakis J, Joyeux H
Department of Surgical Oncology and Nutrition, University of Montpellier, France.
Surg Gynecol Obstet. 1993 Jun;176(6):575-80.
The development of a fistula is a serious postoperative complication. Conservative medical treatment with total parenteral nutrition, skin care and intensive infection control usually succeeds in closing fistulas (60 to 75 percent), but the treatment is of long duration (two to three months), high cost and high morbidity related to prolonged hospitalization. We have used octreotide, a long half-life stomatostatin analog, in 40 patients from two European university centers with postoperative enterocutaneous fistulas. Twenty-two patients had low fistula output and 28 patients had high fistula output. Spontaneous closure was achieved in 77.5 percent of the patients after a mean of 13.6 days. One patient died. Glucose intolerance, which has been reported with stomatostatin treatment of fistulas, was not observed. Previous chemotherapy or radiotherapy or low albumin level (23 grams per deciliter) negatively influenced fistula closure. As an adjunct treatment to primary care (total parenteral nutrition, skin care and infection control), octreotide is efficient in reducing fistula output and accelerating spontaneous fistulas closure.
瘘管形成是一种严重的术后并发症。采用全胃肠外营养、皮肤护理及强化感染控制的保守药物治疗通常能成功闭合瘘管（成功率为60%至75%），但治疗时间长（两至三个月）、费用高且因住院时间延长导致发病率高。我们在来自两个欧洲大学中心的40例术后肠皮肤瘘患者中使用了长效生长抑素类似物奥曲肽。22例患者瘘管排出量低，28例患者瘘管排出量高。平均13.6天后，77.5%的患者实现了自发闭合。1例患者死亡。未观察到生长抑素治疗瘘管时曾报道的葡萄糖不耐受情况。既往化疗或放疗或低白蛋白水平（每分升23克）对瘘管闭合有负面影响。作为初级护理（全胃肠外营养、皮肤护理及感染控制）的辅助治疗，奥曲肽在减少瘘管排出量及加速瘘管自发闭合方面有效。
