Fístulas enterocutâneas pós-operatórias: análise de 39 pacientes

Torres, Orlando Jorge Martins; Salazar, Rosimarie Moraes; Costa, Jackeliny Garcia; Corrêa, Flavia Carvalhal Frazão; Malafaia, Osvaldo

doi:10.1590/s0100-69912002000600010

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…Bradley et al 8 found that 20% of patients were older than 55 years, with a 79% prevalence of men 8,9 . There was a predominance of emergency surgery, but the incidence of fistula was observed with the highest proportion in elective procedures (60.3%), corroborating the study of Torres et al 5 , who found that 69.2% of fistulas took place in elective surgeries. Urgent surgery is a risk factor related to preoperative preparation, since the time for them tends to be shorter, acting as a prognostic factor [5][6][7][8][9] .…”

Section: Discussionsupporting

confidence: 86%

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Epidemiology and outcome of patients with postoperative abdominal fistula

Wercka

Cagol

Melo

et al. 2016

Rev. Col. Bras. Cir.

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A B S T R A C TObjective: to present the epidemiological profile, incidence and outcome of patients who developing postoperative abdominal fistula. Methods: This observational, cross-sectional, prospective study evaluated patients undergoing abdominal surgery. We studied the epidemiological profile, the incidence of postoperative fistulas and their characteristics, the outcome of this complication and the predictors of mortality. Results: The sample consisted of 1,148 patients. The incidence of fistula was 5.5%. There was predominance of biliary fistula (26%), followed by colonic fistulas (22%) and stomach (15%). The average time to onset of fistula was 6.3 days. For closure, the average was 25.6 days. The mortality rate of patients with fistula was 25.4%. Predictors of mortality in patients who developed fistula were age over 60 years, presence of comorbidities, fistula closure time more than 19 days, no spontaneous closure of the fistula, malnutrition, sepsis and need for admission to the Intensive Care Unit . Conclusion: abdominal postoperative fistulas are still relatively frequent and associated with significant morbidity and mortality.

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Section: Discussionsupporting

confidence: 86%

“…At admission, about 35% to 40% of general surgery patients have some degree of malnutrition that may interfere with surgical outcomes 5 , with increase in length of stay, with the need for reoperations and complications, which increase hospital costs and patients' suffering.…”

mentioning

confidence: 99%

Epidemiology and outcome of patients with postoperative abdominal fistula

Wercka

Cagol

Melo

et al. 2016

Rev. Col. Bras. Cir.

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“…Cerca del 80 % de las fístulas enteroatmosféricas corresponden a una complicación de las cirugías abdominales y, a mayor número de reintervenciones, mayor riesgo de desarrollarlas 1,6 . El estado de nutrición del paciente juega un papel importante en el desarrollo de dichas complicaciones.…”

Section: Introductionunclassified

Nueva técnica para control de contaminación de fístulas enteroatmosféricas en abdomen abierto Björck 4. Método de Capilaridad (MECA)

Muñoz-Ruiz

Bravo-Flórez²,

Chaparro

et al. 2021

Rev Colomb Cir

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Introducción. La fístula enteroatmosférica es una patología compleja que puede ser el resultado de múltiples intervenciones quirúrgicas de la cavidad abdominal. Describimos una nueva técnica para el control de la contaminación en pacientes con fístulas enteroatmosféricas en abdomen abierto Björck 4. Métodos. Se realizó un análisis retrospectivo de cuatro pacientes con fístulas enteroatmosféricas desarrolladas como complicación de procedimientos quirúrgicos abdominales. Se trataron integralmente por un grupo multidisciplinario de Cuidados Intensivos, Cirugía general, Soporte nutricional y Cuidado de heridas y ostomías. Se utilizó una novedosa técnica quirúrgica basada en el principio de capilaridad para mantener limpios los tejidos periostomales. Resultados. Con esta técnica se logró el control de la contaminación abdominal en todos los pacientes y una evolución clínica satisfactoria. Posteriormente se programaron para cierre quirúrgico definitivo con éxito. Conclusiones. El manejo de la fístula enteroatmosférica representa un reto para el cirujano y el grupo multidisciplinario que trata al paciente. Esta nueva técnica utilizada en pacientes con fístula enteroatmosférica con abdomen abierto Björck 4 se basa en el principio de capilaridad, y es eficaz en el control de la contaminación, infección y de la sepsis asociada.

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“…The postoperative fistula represents more than 90% of all intestinal fistulae, and is usually one of the main complications related to surgery of the digestive system 4 . Mortality rates resulting from the complications related to intestinal fistulae are still high, ranging from 6.5 to 48%, against the mean of 2% obtained from elective surgical procedures 5 .…”

Section: Introductionmentioning

confidence: 99%

“…In this situation, early surgical intervention is essential to decrease mortality rates. Studies show a 90% mortality rate in patients who presented with sepsis and malnutrition 4 .…”

Section: Introductionmentioning

confidence: 99%

Temporary ileostomy for the preservation of colon fistula in patients with postoperative complications: case report

Patrício¹,

Filho²,

Biazon³

2011

J. Coloproctol. (Rio J.)

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Among the postoperative complications in the digestive system, the fistulae are the most common ones. The changes resulting from these fistulae are very important, once they can determine the patient's situation and the development of multiple organic failures. This paper reports the case of a patient who had relevant complications after having undergone temporary ileostomy to maintain the colon fistulized. About 90 to 95% of the digestive tract fistulae have spontaneous resolution. In some cases, the general state of the patient compromises the spontaneous closure. In this study, after one month of nutritional support and medicine treatment, the spontaneous closure of the colon fistula did not occur, thus, a surgical intervention was necessary to solve the case.
Dentre as complicações pós-operatórias do aparelho digestório, as fístulas apresentam alta incidência. As alterações decorrentes dessas fístulas são muito importantes, pois podem determinar o agravamento do estado geral do paciente e o desenvolvimento de insuficiências orgânicas múltiplas. O presente trabalho relata o caso de um paciente com complicações relevantes após a realização de uma ileostomia temporária para preservação do cólon fistulizado. A maioria (90-95%) das fístulas do trato digestório tem resolução espontânea; entretanto, em alguns casos, o estado geral do paciente compromete o fechamento espontâneo. No caso em estudo, após um mês de suporte nutricional e tratamento medicamentoso, o fechamento espontâneo da fístula de cólon não ocorreu, sendo necessária a intervenção cirúrgica para resolução do caso

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Fístulas enterocutâneas pós-operatórias: análise de 39 pacientes

Cited by 5 publications

References 30 publications

Epidemiology and outcome of patients with postoperative abdominal fistula

Epidemiology and outcome of patients with postoperative abdominal fistula

Nueva técnica para control de contaminación de fístulas enteroatmosféricas en abdomen abierto Björck 4. Método de Capilaridad (MECA)

Temporary ileostomy for the preservation of colon fistula in patients with postoperative complications: case report

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