Endoscopic Treatment of Post Surgical Gastrointestinal Fistulas with Biological Fibrin Glue

Rábago, Luís; Moral, I.; Guerra, Iván; Delgado, María Gabriela; Llorente, Rosa; Castro, JoseLuis; Uribazo, Mauricio; Gea, Francisco; Martinez-Veiga, JoseLuis

doi:10.1016/s0016-5107(05)01278-2

Cited by 2 publications

(4 citation statements)

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“…In 1990, Elefthriadis et al reported seven cases of proximal digestive fistulas with high-volume outputs (minimum 700 ml in 24 hours) that were closed with fibrin gel by means of endoscopy, with a 100 % success rate [24]. Recently, Rabago and colleagues [25] described 15 patients with low-and high-volume output fistulas of the proximal and distal alimentary tract; most of these were external (n = 13) and some were internal (n = 2). The duration of conservative treatment ranged from 10 days to 730 days.…”

Section: Discussionmentioning

confidence: 99%

Fibrin Glue as Adjuvant Treatment for Gastrocutaneous Fistula after Gastrostomy Tube Removal

González-Ojeda¹,

Ávalos-González²,

Muciño-Hernández³

et al. 2004

Endoscopy

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Gastrocutaneous fistulas are infrequent after gastrostomy tube removal. However, if the fistulous tract remains permeable, even low-volume output can produce significant cutaneous burns. The use of biodegradable adhesives has been described, where fibrin glue is applied directly over the fistulous tract or under the guidance of procedures such as upper or lower gastrointestinal endoscopy or fistuloscopy. We studied the use of fibrin glue in five consecutive adult patients with gastrocutaneous fistulas after gastrostomy tube removal, with no complications that might impede spontaneous closure. A comparison group included seven patients treated during the preceding 2 years with conservative medical management, who were not treated with fibrin glue. There was no difference between the two groups with regard to age and gender, nor with regard to type of gastrostomy (surgical or endoscopic). The mean output volume from the fistulas was 151.4 +/- 146.1 ml/24 h in the study group and 115.0 +/- 42.7 ml/24 h in the control group, which was not significantly different ( P = 0.80). The duration of previous conservative treatment was 93.8 +/- 85.1 days for the study group and 95.8 +/- 80.7 days for the control group and this also did not differ significantly ( P = 0.93). The time to achieve total fistula closure was 7.0 +/- 3.1 days in the study group and 32.7 +/- 15.7 days in the control group. This difference was statistically significant ( P < 0.004). The time required before oral feeding could be recommenced after spontaneous or induced closure was similar in the two groups, at 2.8 +/- 1.3 days and 4.71 +/- 2.36 days, respectively. Endoscopic guidance allows direct instillation of fibrin glue via the external opening through the whole fistulous tract. This procedure reduces the time required for the closure of gastrocutaneous fistulas.

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Section: Discussionmentioning

confidence: 99%

Fibrin Glue as Adjuvant Treatment for Gastrocutaneous Fistula after Gastrostomy Tube Removal

González-Ojeda¹,

Ávalos-González²,

Muciño-Hernández³

et al. 2004

Endoscopy

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“…Ramón Rábago et al [43] , recently reported the largest series of postoperative digestive fistulas treated with transendoscopic application of fibrin glue. They included 30 patients with proximal, distal and internal fistulas of low-and high-output.…”

Section: Discussionmentioning

confidence: 99%

“…After follow-up periods ranging from 6 mo to more than 6 years, only one of the sealed fistulas reopened requiring a new endoscopic resealing. Rabago and his colleagues concluded that endoscopic treatment achieves a very high success rate, without complications and at a lower cost [43] .…”

Section: Discussionmentioning

confidence: 99%

“…Morbidity related to nutritional support was higher in the control group due to the prolonged time to feeding, and mortality was secondary to catheter-related sepsis in chronic parenteral nutrition. Since accelerated closure was not the purpose of this study, we proposed to treat patients as soon as the fistulas became stable and low-output without any associated obstruction, infection or residual disease, as other authors suggested in treatment of this complication [32,43,45] .…”

Section: Discussionmentioning

confidence: 99%

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Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant

Ávalos-González

Portilla-deBuen²,

Leal-Cortés³

et al. 2010

WJG

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Endoscopic Treatment of Post Surgical Gastrointestinal Fistulas with Biological Fibrin Glue

Cited by 2 publications

References 0 publications

Fibrin Glue as Adjuvant Treatment for Gastrocutaneous Fistula after Gastrostomy Tube Removal

Fibrin Glue as Adjuvant Treatment for Gastrocutaneous Fistula after Gastrostomy Tube Removal

Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant

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