Outcome of acute intestinal failure

Atema, Jasper J.; Mirck, B.; Arum, I. van; Dam, Suzanne Marije ten; Serlie, Mireille J.; Boermeester, Marja A.

doi:10.1002/bjs.10094

Cited by 19 publications

(28 citation statements)

References 20 publications

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“…In another study [ 27 ], in which 52% of the patients required preoperative PN, all but two could discontinue PN. In two other studies [ 25 , 29 ], with 80 and 100% of the patients requiring PN preoperatively, respectively, 86 and 79% of the patients were able to discontinue PN postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…Although the median time to surgery was reported in thirteen of the fifteen studies, a wide range of time to surgery within a study as well as a large variation in follow-up after surgery was present. For example, Rahbour et al [ 29 ] described 149 patients with a median time to surgery of 360 days. The time to surgery, however, varied between 30 and 5100 days, and interquartile ranges were not provided.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review and Meta‐analysis of Timing and Outcome of Intestinal Failure Surgery in Patients with Enteric Fistula

et al. 2017

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BackgroundThe timing of intestinal failure (IF) surgery has changed. Most specialized centers now recommend postponing reconstructive surgery for enteric fistula and emphasize that abdominal sepsis has to be resolved and the patient’s condition improved. Our aim was to study the outcome of postponed surgery, to identify risk factors for recurrence and mortality, and to define more precisely the optimal timing of reconstructive surgery.MethodsPubMed, Embase, and the Cochrane Library were systematically reviewed on the outcomes of reconstructive IF surgery (fistula recurrence, mortality, morbidity, hernia recurrence, total closure, enteral autonomy). If appropriate, meta-analyses were performed. Optimal timing was explored, and risk factors for recurrence and mortality were identified.ResultsFifteen studies were included. The weighted pooled fistula recurrence rate was 19% (95% CI 15–24). Lower recurrence rates were found in studies with a longer median time and/or, at the minimum of the range, a longer time interval to surgery. Overall mortality was 3% (95% CI 2–5). Total fistula closure rates ranged from 80 to 97%. Enteral autonomy after reconstructive surgery, mentioned in four studies, varied between 79 and 100%.ConclusionsPostponed IF surgery for enteric fistula is associated with lower recurrence. Due to the wide range of time to definitive surgery within each study, optimal timing of surgery could not be defined from published data.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta‐analysis of Timing and Outcome of Intestinal Failure Surgery in Patients with Enteric Fistula

et al. 2017

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“…Sources of contamination such as the presence of a stoma, concomitant bowel surgery, enterocutaneous fistulas (ECF) or infected mesh increase the risk of wound complications [1,2]. Additionally, patients may have coexisting intestinal failure, possibly worsening postoperative morbidity [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes after contaminated complex abdominal wall reconstruction

Vries

Hodgkinson

Claessen

et al. 2020

Hernia

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Purpose Complex abdominal wall repair (CAWR) in a contaminated operative field is a challenge. Available literature regarding long-term outcomes of CAWR comprises studies that often have small numbers and heterogeneous patient populations. This study aims to assess long-term outcomes of modified-ventral hernia working group (VHWG) grade 3 repairs. Because the relevance of hernia recurrence (HR) as the primary outcome for this patient group is contentious, the need for further hernia surgery (FHS) was also assessed in relation to long-term survival. Methods A retrospective cohort study with a single prospective follow-up time-point nested in a consecutive series of patients undergoing CAWR in two European national intestinal failure centers. Results In long-term analysis, 266 modified VHWG grade 3 procedures were included. The overall HR rate was 32.3%. The HR rates for non-crosslinked biologic meshes and synthetic meshes when fascial closure was achieved were 20.3% and 30.6%, respectively. The rates of FHS were 7.2% and 16.7%, and occurred only within the first 3 years. Bridged repairs showed poorer results (fascial closure 22.9% hernia recurrence vs bridged 57.1% recurrence). Overall survival was relatively good with 80% en 70% of the patients still alive after 5 and 10 years, respectively. In total 86.6% of the patients remained free of FHS. Conclusions In this study of contaminated CAWR, non-crosslinked biologic mesh shows better results than synthetic mesh. Bridging repairs with no posterior and/or anterior fascial closure have a higher recurrence rate. The overall survival was good and the majority of patients remained free of additional hernia surgery.As 80% of patients are still alive at 5-year follow-up and 86.6% of the patients remained free of additional surgery, the initial higher costs of a non-crosslinked biologic mesh seem trivial.

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“…The Academic Medical Center (AMC) is a national referral centre in the Netherlands for patients with acute and chronic IF since 1986. Recently, the long‐term results of patients treated at the multidisciplinary out‐patient clinic of the AMC were reported . At time of referral most patients are on a wide variety of medication prescribed to reduce output in the acute phase of IF.…”

Section: Resultsmentioning

confidence: 99%

Systematic review: pharmacotherapy for high‐output enterostomies or enteral fistulas

Vries

Reeskamp

Ruler

et al. 2017

Aliment Pharmacol Ther

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Outcome of acute intestinal failure

Abstract: Intestinal failure care and reconstructive surgery resulted in successful discontinuation of PN in the majority of patients, although disease-related mortality was considerable.

Cited by 19 publications

References 20 publications

A Systematic Review and Meta‐analysis of Timing and Outcome of Intestinal Failure Surgery in Patients with Enteric Fistula

A Systematic Review and Meta‐analysis of Timing and Outcome of Intestinal Failure Surgery in Patients with Enteric Fistula

Long-term outcomes after contaminated complex abdominal wall reconstruction

Systematic review: pharmacotherapy for high‐output enterostomies or enteral fistulas

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