Management of fistula of ileal conduit in open abdomen by intra-condoit negative pressure system

Yetışır, Fahri; Salman, A. Ebru; Aygar, Muhittin; Yaylak, Faik; Aksoy, Şemsi Mustafa; Yalçın, Abdussamet

doi:10.1016/j.ijscr.2014.04.030

Cited by 14 publications

(18 citation statements)

References 15 publications

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“…Though there is no recommendation of NPS in the treatment of urinary fistula following ileal conduit, NPS had often been used in complicated wounds, and its uniform negative pressure could enhance wound healing. In some complicated cases with urine leakage, NPS was associated with favorable outcome [15][16] . In this study, intra-conduit NPS also resulted in a favorable outcome as a conservative procedure.…”

Section: Discussionmentioning

confidence: 98%

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A simple method for conservative treatment of urinary fistula following ileal conduit

Heng²,

Tan³

et al. 2019

Preprint

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Section: Discussionmentioning

confidence: 98%

“…In sparse reports, it also revealed a promising outcome for the management of urinary fistula [15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

A simple method for conservative treatment of urinary fistula following ileal conduit

Heng²,

Tan³

et al. 2019

Preprint

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“…After debridement and irrigation with warm saline, NPT was applied to all OA patients under general anesthesia. If there was an EAF within an OA, different types of EAF control strategies based on fistula type were used in conjunction with the standard abdominal NPT dressing [18,19]. Delayed abdominal closure was considered after hemodynamic stabilization of the patient, source control of the OA, regression of sepsis, and decrease in procalcitonin level to <1.0 ng/dl [20].…”

Section: Methodsmentioning

confidence: 99%

Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm

Yetışır¹,

Sarer²,

Acar³

et al. 2015

Indian J Surg

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Hemodynamic resuscitation, source control, and delayed abdominal closure are the three fundamental steps for open abdomen (OA) management. When to start delayed abdominal closure and how to determine which delayed closure method should be applied to each OA patient are not clarified in the literature. We evaluated an algorithm that was developed to address these two questions. A retrospective chart review was conducted for OA patients treated for according to the algorithm. When hemodynamic stabilization and source control using negative pressure therapy resulted in regression of sepsis and decreased procalcitonin levels, patients were assigned to either the skin-only or fascial closure groups according to their Björck scores and open abdominal fascial closure (OAFC) scores. The novel OAFC scoring system was created by adding age and malignancy to the sequential organ failure assessment (SOFA) score. For skin-only closure, skin flaps and skin grafts were used; for fascial closure, an abdominal re-approximation anchor system (ABRA) or ABRA plus biologic mesh was applied. From January 2008 through September 2014, 108 OA patients were managed based on the algorithm; 61 were included in this study. Abdominal closure rate was 90.2 % (55/61). Overall hospital mortality rate was 11.4 % (7/61). Small hernias developed in only 12.5 % (4/32) of the fascial closure group. In this retrospective study, the algorithm with the novel OAFC score provided practical and valid guidance to clarify when to start delayed abdominal closure and which delayed closure method to use for each OA patient.

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“…Negative pressure system (NPS) drainage has generally been used to cure complicated wounds [12][13][14] . In a sparse number of reports, NPS drainage has also been revealed as a promising outcome in the management of urinary fistula [15][16][17] . Therefore, we tried to use an intra-conduit NPS as a conservative way to cure patients who had suffered from urine leakage after ileal conduit urinary diversion since 2012.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

Liang²,

Tan³

et al. 2019

Preprint

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Background The presence of urinary fistula after ileal conduit urinary diversion is a challenging complication , and this study investigated the role of the intra-conduit negative pressure system (NPS) in the presence of urinary fistula following ileal conduit (IC) urinary diversion as a conservative treatment. Methods Using the intra-conduit NPS, a minor drainage tube was placed within a silicon tube to suck urine from the conduit with consistent negative pressure. Patients with urinary fistula following IC from August 2012 to July 2017 were recorded, and the clinical characteristics and outcome were retrospectively analyzed. Results The intra-conduit NPS was used as a primarily conservative treatment for 13 patients who suffered from urinary fistula and presented with a large amount of abdominal/pelvic drainage without other significant morbidities. The median age was 60 years old (42-74 years), and 7 patients were male. The median duration between the IC operation and the presence of urinary fistula was 15 days (2-28 days), and elevated creatinine levels were detected in the abdominal/pelvic drainage with a median level of 2114 µmol/L (636-388 µmol/L). A significant decrease in abdominal/pelvic drainage was identified in 12 patients. The median time that the NPS was used was 9 days (7-11 days). The other patient did not show any improvements after 2 days of observation and then underwent open surgery. With ureteral stenting, 2 abdominal drainage tubes and the intra-conduit NPS were placed during operation, no urine leakage was observed in the abdominal/pelvic field, and the patient was cured in 9 days. With a median follow-up of 22 months, no fistula recurrence or hydronephrosis was detected. Conclusion The intra-conduit negative pressure system is a feasible and promising way to cure urinary fistula following ileal conduit urinary diversion. Because this procedure is a mini-invasive and simple approach, it might represent an alternative in selected patients.

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Management of fistula of ileal conduit in open abdomen by intra-condoit negative pressure system

Cited by 14 publications

References 15 publications

A simple method for conservative treatment of urinary fistula following ileal conduit

A simple method for conservative treatment of urinary fistula following ileal conduit

Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

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