Extracellular Matrix Enterocutaneous Fistula Plugs Show Promise for Low-Flow Colocutaneous and Enterocutaneous Fistulae
| Autor: | Ziga Cizman, Ryan O’Hara, R. Hardman, Tyler A. Smith, Luke Jenkins, Keyan Marashi |
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| Rok vydání: | 2019 |
| Předmět: |
Enterocutaneous fistula
Adult Gastric Fistula Male Reoperation medicine.medical_specialty Fistula Cutaneous Fistula Colonic Diseases Postoperative Complications Interquartile range Patient age Intestinal Fistula Medicine Humans Radiology Nuclear Medicine and imaging In patient Major complication Single institution Aged Retrospective Studies Aged 80 and over Wound Healing business.industry Retrospective cohort study Middle Aged medicine.disease Surgery Extracellular Matrix Treatment Outcome Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of vascular and interventional radiology : JVIR. 32(1) |
| ISSN: | 1535-7732 |
| Popis: | Purpose To evaluate extracellular matrix enterocutaneous fistula plugs (ECMFPs) in treatment of enteric fistulae at a single institution. Materials and Methods The study included 18 patients who had an ECMFP placed between 2012 and 2018 with treatment follow-up through July 2020. Median patient age was 52.5 years (interquartile range, 11.5 y). There were 28 ECMFP procedures performed on 19 separate fistulae. Fistulae locations were gastrocutaneous (n = 4), enterocutaneous (n = 9), and colocutaneous (n = 6). Descriptive statistics were used to define closure rates, recurrence rates, and complications. Results Fistula closure was achieved in 1 of 4 gastrocutaneous (25%), 4 of 9 enterocutaneous (44%), and 3 of 6 colocutaneous (50%) locations. The median time from procedure to fistula tract closure was 29 days interquartile range 25 days. The median time from ECMFP placement to fistula recurrence was 28 days (interquartile range 27 days). Of the fistulae that eventually closed, 6 of 8 closed after the first attempt (75%), and 2 closed after the second attempt (25%). Of the procedures that resulted in complete closure, 7 of 8 were categorized as low flow, and 1 of 8 was categorized as high flow. Complications were seen in 4 patients (23%), with major complications in 3 patients (17%). Conclusions Low-flow fistulae originating from the small bowel are most likely to have complete closure. High-flow and/or gastrocutaneous fistulae are less likely to benefit from this intervention. In patients who are not surgical candidates or who have failed surgical management, ECMFPs may provide a solution. |
| Databáze: | OpenAIRE |
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