Characterization of Postoperative Enterocutaneous Fistulas

Abstract

Introduction: Enterocutaneous fistulas are a serious disease that a large number of surgeons must face during the practice of their profession. Their treatment is usually extremely complex and always requires a multidisciplinary intervention adapted to each particular case.

Objective: To evaluate the clinical-epidemiological and therapeutic characteristics of postoperative enterocutaneous fistulas.

Methods: An observational and descriptive study was performed, with prospective data collection, in the five-year period 2013-2017. The study universe was 28 patients diagnosed with postoperative enterocutaneous fistula. The following variables were used: age, sex, nature of the intervention, operative diagnosis, type of fistula, definitive treatment, complications and treatment cornerstones.

Results: The mean age was 49 years. Fistulas were more frequent in the female sex (53.57 %). 78.57 % of the patients underwent emergency surgery, while 25 % had an operative diagnosis of mechanical intestinal occlusion due to adherences, followed by intestinal occlusion due to left colon tumor (17.86 %). Left hemicolectomy with end-to-end anastomosis (21.43 %) and intestinal resection with end-to-end anastomosis (17.86 %) were the main surgical procedures.

Conclusions: Type II and low-output fistulas prevailed in the case series at a mean time that corresponds to that reported in the literature. Surgical site infection was the most frequently observed complication, while the treatment cornerstones were fulfilled in most patients, with spontaneous closure prevailing as a definitive treatment.