[Conservative treatment of the digestive fistulas: personal experience].

Autor:	Castriconi M; AORN A Cardarelli, Napoli UOC Chirurgia d'Urgenza., Romagnuolo G, Giuliano ME, Bartone G, Chianese F, Maglio MN, Molino C, Festa P, Zito ES, De Sena G
Jazyk:	italština
Zdroj:	Annali italiani di chirurgia [Ann Ital Chir] 2005 Nov-Dec; Vol. 76 (6), pp. 523-7.
Abstrakt:	Objective: The authors, thanks to experience obtained in an Unit for the treatment of digestive fistulas, discuss the possibility of a conservative treatment for the anastomotic fistulas. Material and Methods: From 2000 to 2003 were treated thirty-five patients with post-anastomotic gastroenteric fistulas marked according to their localization, way end output (51.5% high, 42.8% moderate and 5.7% low). The treatment is based on an aspiration system, sometimes integrated with an irrigation system. A semi-permeable barrier was created over the fistula by vacuum packing a synthetic, hydrophobic, polymer covered with a self-adherent surgical sheet. This system create a vacuum chamber equipped with a subathmospheric pressures between 262.2 and 337.5 mmHg (350-450 mmbar), integrated with a continuous irrigation using antibiotic solutions or 3% lactic acid. Results: The AA. obtained the resolution in 30 patients (85.7%), 3 patients needs the surgery (8.6%), 2 died, one for sepsis and the other one for malnutrition. The mean time for the closure was 45 days (from 20 to 90). A part of digestive external fistulas goes to spontaneous resolution so comes the idea that the creation of particular condition is the basis of their closure.
Databáze:	MEDLINE
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