Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant
| Autor: | Clotilde Fuentes-Orozco, Alejandro González-Ojeda, María del Carmen Estrada-Aguilar, Jorge Ávalos-González, Gabriela Abigail Velázquez-Ramírez, Aldo Emmerson Guzmán-Gurrola, Caridad Leal-Cortés, Gabriela Ambriz-González, Eliseo Portilla-de-Buen, Abel Orozco-Mosqueda |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Brief Article medicine.medical_treatment Treatment outcome Fibrin Tissue Adhesive Fibrin Postoperative Complications Intestinal Fistula medicine Humans Postoperative Period Prospective Studies Reduction (orthopedic surgery) biology business.industry Sealant Tissue adhesives Gastroenterology General Medicine Middle Aged Surgery Treatment Outcome Case-Control Studies Anesthesia biology.protein Female Tissue Adhesives business |
| Zdroj: | World Journal of Gastroenterology. 16:2793 |
| ISSN: | 1007-9327 |
| DOI: | 10.3748/wjg.v16.i22.2793 |
| Popis: | To assess whether the use of fibrin sealant shortens the closure time of postoperative enterocutaneous fistulas (ECFs).The prospective case-control study included 70 patients with postoperative ECFs with an output of500 mL/d, a fistulous tract of2 cm and without any local complication. They were divided into study (n = 23) and control groups (n = 47). Esophageal, gastric and colocutaneous fistulas were monitored under endoscopic visualization, which also allowed fibrin glue application directly through the external hole. Outcome variables included closure time, time to resume oral feeding and morbidity related to nutritional support.There were no differences in mean age, fistula output, and follow-up. Closure-time for all patients of the study group was 12.5 +/- 14.2 d and 32.5 +/- 17.9 d for the control group (P0.001), and morbidity related to nutritional support was 8.6% and 42.5%, respectively (P0.01). In patients with colonic fistulas, complete closure occurred 23.5 +/- 19.5 d after the first application of fibrin glue, and spontaneous closure was observed after 36.2 +/- 22.8 d in the control group (P = 0.36). Recurrences were observed in 2 patients because of residual disease. One patient of each group died during follow-up as a consequence of septic complications related to parenteral nutrition.Closure time was significantly reduced with the use of fibrin sealant, and oral feeding was resumed faster. We suggest the use of fibrin sealant for the management of stable enterocutaneous fistulas. |
| Databáze: | OpenAIRE |
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