2010, Number 591
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Rev Med Cos Cen 2010; 67 (591)
Fístulas de tubo digestivo manejo médico y quirúrgico
Sánchez AM, Solís CP
Language: Spanish
References: 27
Page: 5-9
PDF size: 313.58 Kb.
ABSTRACT
Fistulas are defined as a comunication betwen a revested structure by epitelium to the exterior. In most cases is caused by surgery and the mortality rate has been reduced due to the integral treatment with antibiotics, nutrition, octreotide and surgery.
In this publicaction we reviwed the files with the diagnosis of fistula in the Calderon Guardia Hospital between the years 2001 and 2005 to compare the management and results with the world actual conduct. 214 files were reviwed but only 87 were able to study. Of the results we have 59,6% are male, and 40,4 female, with and average age of 53,8 years in both sex. The most frecuent site for fistulas were small bowel followed by bile tree and colon. The 77% of cases were of low output and 89,7% postoperative, only 36,8% made localization studies. Almost all of the upper fistulas were treated medically with good results and the fistulas of colon 60% surgically, although the 39,4% with medical treatment of colon gave good results.
As a conclusion we can state that fistulas are a frecuent surgery complication, The oportune diagnosis and to stablish a management work plan since the begining will give good evolution and will diminish the morbility and mortality of this problem.
REFERENCES
Aguirre A; Fisher JE. The role of hyperalimentation in therapy of gastrointestinal cutaneous fistulae. Ann Surg 1974; 180: 393.
Berry SM; Fisher JE. Classification and pathophysiology of enterocutaneos fistula. Surg Clin N Am 1996; 76: 1009-18.
Cothren C; Mcintyre R. Management of low-output pancreatic fistulas with fibrin glue. Am J Surg 2004; 188: 89-91.
Davids PH; Rauws EA. Posoperative bile leakage: endoscopic management.. Gut 1992; 33: 1118-22.
Deitel M. Nutritional management of external gastrointestinal fistulas. Can J Surg 1976; 19: 505.
Dudrick SJ; Maharaj AR. Artificial nutrition support in patients with gastrointestinal fistulas. World J Surg 1999;23:570-76.
Falconi M; Pederzoli P. The relevante of gastrointestinal fistula in clinical practice:a review. Gut 2001;49:2-10.
Falconi M; Sartori N. Management of digestive tract fistulas. A review. Digestion 1999; 60(supl3):51-58.
Fazio V; Coutsoftides T. Factors influencing the outcome of treatment of small bowel cutaneous fistula.. World J Surg. 1983; 7: 481-88.
Fisher JE. The pathophysiology of enterocutaneous fistulas. World J Surg. 1983; 7: 446.
Gallad RB; Spencer J. Radiation-induced gastrointestinal fistulae. Ann R Coll Surg Engl 1986; 68:5-7.
Gonzálesz I; Moreno E. Optimizing the treatment of upper gastrointestinal fistulae. Gut 2001; 49: 21-28.
Gouillat C; Gigot JF. Pancreatic surgical complicactions- the case for prophylaxis. Gut 2001; 49: 29-35.
Guitron A; Adalid R. Endoscopic and managentof biliary fistula.. Rev. Gastroenterol Mex 1997; 62: 29-33.
Hesse U; Ysebaert. Role of somatostatin-14 and his analogues in the management of gastrointestinal fistulae: clinical data. Gut 2001;49:11-20.
Hill G. Operative strategy in the treatment of enterocutaneous fistulas. World J Surg 1983; 7: 495-501.
Lynch A; Delaney C. Clinical outcome and factors predictive recurrence after enterocutaneous fistula surgery. Ann Surg 2004;240: 825-31.
Macfadyen BV; Dudrick SJ. Management of gastrointestinal fistulas with parenteral hyperalimentation. Surgery 1973; 74: 100.
Martineau P; Shwed JA. Is octreótido a new hope for enterocutaneos and external pancreatic fistula closure?. Am J Surg 1996;172:368-95.
Mervyn D. Elemental diet and enterocutaneous fistula. World J Surg 1983; 7: 451-54.
Pederlozi P; Bassi C. Conservative treatment of external pancreatic fistulas with parenteral nutrition alone or in combination with continuos intravenous infusion of somatostatina, glucagon or calcitonin. Surg. Gynecol. Obstet. 1986; 163: 428-32.
Reber H; Way L. Management of external gastrointestinal fistulas. Ann Surg. 1978; 188: 460.
Rolandelli R; Roslyn JJ. Surgycal management and treatment of sepsis associated with gastrointestinal fistulas Surg. Clin. North Am. 1996; 76: 1111-22.
Rosenberg L; Macneil P. Economic evaluation of the use of the octreotide for prevention of complications following pancreatic resection. J. Gastrointest Surg. 1999; 3: 225-32.
Rubelowsky J; Machiedo GW. Reoperative versus conservative management of gastrointestinal fistulas. Surg. Clin N Am. 1991; 71: 147-57.
Thomas H. Radiologic investigation and treatment of gastrointestinal fistulas. Surg. Clin. North Am. 1996; 76: 1081-94.
Zinner MJ; Cameron Jl. Pnacreatic cutaneos fistulas. Surg. Gynecol. Obstet. 1974; 138: 710-12.