IFLYSIB   05383
INSTITUTO DE FISICA DE LIQUIDOS Y SISTEMAS BIOLOGICOS
Unidad Ejecutora - UE
artículos
Título:
Treatment of High-output Enterocutaneous Fistulas with a Vacuum-compaction Device. A Ten-year Experience
Autor/es:
WAINSTEIN DANIEL EDGARDO; FERNANDEZ ERNESTO; GONZALEZ DANIEL; CHARA OSVALDO; BERKOWSKI DARÍO
Revista:
WORLD JOURNAL OF SURGERY.
Editorial:
Springer
Referencias:
Lugar: New York; Año: 2008 vol. 32 p. 430 - 435
ISSN:
0364-2313
Resumen:
Background: Enterocutaneous fistulas arise as complications
in 0.8%2% of abdominal operations. The global
mortality rate is 5%37%, yet it may exceed 60% in the
case of high-output fistulas and when sepsis and malnutrition
are involved. The objective of this prospective
cohort study with retrospective data analyses was to analyze
our ten-year experience with a vacuum-compaction
device for the management of high-output, postoperative
enterocutaneous fistulas at the Department of General
Surgery, E. Tornu´ Hospital, and the Intensive Care Unit,
Churruca Hospital, Buenos Aires, Argentina.Enterocutaneous fistulas arise as complications
in 0.8%2% of abdominal operations. The global
mortality rate is 5%37%, yet it may exceed 60% in the
case of high-output fistulas and when sepsis and malnutrition
are involved. The objective of this prospective
cohort study with retrospective data analyses was to analyze
our ten-year experience with a vacuum-compaction
device for the management of high-output, postoperative
enterocutaneous fistulas at the Department of General
Surgery, E. Tornu´ Hospital, and the Intensive Care Unit,
Churruca Hospital, Buenos Aires, Argentina.
Patients and methods: Ninety-one patients presented 179
fistulas; 73 (69.2%) were men whose mean age was 48 years.
Sepsis and malnutrition were present in 66 (72.5%). The
mean initial fistula output was 1,485 ml/day. Conservative
management was carried out according to diagnostic and
therapeutic priority staging. A vacuum-compaction system
(SIVACO; Spanish acronym) was used to control output.Ninety-one patients presented 179
fistulas; 73 (69.2%) were men whose mean age was 48 years.
Sepsis and malnutrition were present in 66 (72.5%). The
mean initial fistula output was 1,485 ml/day. Conservative
management was carried out according to diagnostic and
therapeutic priority staging. A vacuum-compaction system
(SIVACO; Spanish acronym) was used to control output.
Results: Output was entirely suppressed in 37 (40.7%)
patients after 17 days of treatment, and reduced to less
than 500 ml/day (average = 138) in 52 (57.1%) patients.
Spontaneous closure was achieved in 42 (46.2%) patients,
whereas 37 (40.7%) patients did not improve after 20380
(average = 111) days of treatment. Those patients required
surgical correction, which had an 83.8% success rate.
Overall mortality was 16.5% (15 patients).
Conclusions: The vacuum-compaction device proved
effective for reducing fistula output in 89 of 91 patients
(97.8%).The vacuum-compaction device proved
effective for reducing fistula output in 89 of 91 patients
(97.8%).Output was entirely suppressed in 37 (40.7%)
patients after 17 days of treatment, and reduced to less
than 500 ml/day (average = 138) in 52 (57.1%) patients.
Spontaneous closure was achieved in 42 (46.2%) patients,
whereas 37 (40.7%) patients did not improve after 20380
(average = 111) days of treatment. Those patients required
surgical correction, which had an 83.8% success rate.
Overall mortality was 16.5% (15 patients).
Conclusions: The vacuum-compaction device proved
effective for reducing fistula output in 89 of 91 patients
(97.8%).The vacuum-compaction device proved
effective for reducing fistula output in 89 of 91 patients
(97.8%).