Conservative treatment of the digestive fistulas: Personal experience

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Maurizio Castriconi
Giuseppe Romagnuolo
Maria Elena Giuliano
Giovanni Bartone
Francesco Chianese
Mauro Natale Domenico Maglio
Carlo Molino
Patrizio Festa
Enzo Saverio Zito
Guido De Sena
Antonio Martino
Rossana Martino

Abstract

OBJECTIVE: The authors, thanks to experience obtained in a 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 creates a vacuum chamber equipped with a subatmospheric 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.

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How to Cite
Castriconi, Maurizio, et al. “Conservative Treatment of the Digestive Fistulas: Personal Experience”. Annali Italiani Di Chirurgia, vol. 76, no. 6, Nov. 2005, pp. 523-7, https://annaliitalianidichirurgia.it/index.php/aic/article/view/903.
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