Kearney R, Payne W, Rosemurgy A
Department of Surgery, University of South Florida, Tampa, USA.
Am Surg. 1997 May;63(5):406-9.
Enterocutaneous fistula is a dread complication of gastrointestinal disease and gastrointestinal operation. These patients typically have undergone numerous abdominal operations, often with peritoneal contamination, carcinoma, and/or a history of radiation, making operation for repair daunting, if not impossible. We describe a method for closure of enterocutaneous fistula, which we have used successfully in four such patients. After failure of nonsurgical management, each patient's fistula was closed with a combination of skin, muscle, and fascial flaps after intubation of the fistula with a Malecot catheter. No intra-abdominal dissection was necessary. All fistulas healed completely. We recommend this closure in any patient who has failed surgical or nonsurgical therapy or in whom celiotomy is contraindicated or is to be avoided.
肠皮肤瘘是胃肠道疾病和胃肠道手术的可怕并发症。这些患者通常接受过多次腹部手术，常伴有腹腔污染、癌症和/或放疗史，这使得修复手术即使并非不可能，也令人生畏。我们描述了一种闭合肠皮肤瘘的方法，我们已在4例此类患者中成功应用。在非手术治疗失败后，通过用马勒科特导管插入瘘管，然后联合使用皮瓣、肌瓣和筋膜瓣闭合每位患者的瘘管。无需进行腹腔内解剖。所有瘘管均完全愈合。对于手术或非手术治疗失败的患者，或开腹手术禁忌或应避免开腹手术的患者，我们建议采用这种闭合方法。
