Tratamiento endoscópico de fístulas gastrointestinales con un pegamento biológico tisular

Rábago, Luís; Moral, I.; Delgado, María del Pilar Gutiérrez; Guerra, Iván; Quintanilla, E.; Castro, José Luis; Llorente, Rosa Patricia Arias; Veiga, José; Gea, Francisco

doi:10.1157/13091451

Cited by 13 publications

(3 citation statements)

References 30 publications

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“…The treatment of gastrocutaneous fistulas with biological glue has been reported on different occasions [3, 9, 10]. Papavramidis et al demonstrated the endoscopic application of a fibrin sealant under direct vision via a double lumen catheter passed through a forward viewing endoscope, safely and effectively [3].…”

Section: Case Discussionmentioning

confidence: 99%

Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report

Kouklakis

Zezos

Liratzopoulos

et al. 2011

Diagnostic and Therapeutic Endoscopy

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The over-the-scope-clip (OTSC; Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed method for the mechanical compression of large areas in the gastrointestinal tract. So far, indications for OTSC application are hemostasis of primary or postinterventional bleeding, closure of iatrogenic full-thickness or covered perforations. Recently closure of gastrointestinal tract fistulas using this device has been described. A 44-year-old man developed a gastrocutaneous fistula after surgical treatment for a perforated gastric ulcer. We describe the successful endoscopic closure of the fistula using the OTSC system. The patient's clinical followup was uneventful. Fistula closure was successfully implemented as it was documented by imaging and endoscopic examinations performed on the 2nd day and 6th week after the application of the clip. Endoscopic application of the OTSC device was safe and effective for the treatment of a gastrocutaneous fistula.

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Section: Case Discussionmentioning

confidence: 99%

Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report

Kouklakis

Zezos

Liratzopoulos

et al. 2011

Diagnostic and Therapeutic Endoscopy

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“…Ramón Rábago et al[ 103 ] reported their experience in fistula closure with fibrin glue in a case series of 30 patients, refractory to standard conservative treatment. Complete sealing of fistulas was achieved in 75% of cases (80% in low-output, 25% in high-output and 55.5% in internal fistulas).…”

Section: Tissue Sealantmentioning

confidence: 99%

Endoscopic management of gastrointestinal leaks and fistulae: What option do we have?

Cereatti

Grassia

Drago

et al. 2020

WJG

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Gastrointestinal leaks and fistulae are serious, potentially life threatening conditions that may occur with a wide variety of clinical presentations. Leaks are mostly related to post-operative anastomotic defects and are responsible for an important share of surgical morbidity and mortality. Chronic leaks and long standing post-operative collections may evolve in a fistula between two epithelialized structures. Endoscopy has earned a pivotal role in the management of gastrointestinal defects both as first line and as rescue treatment. Endotherapy is a minimally invasive, effective approach with lower morbidity and mortality compared to revisional surgery. Clips and luminal stents are the pioneer of gastrointestinal (GI) defect endotherapy, whereas innovative endoscopic closure devices and techniques, such as endoscopic internal drainage, suturing system and vacuum therapy, has broadened the indications of endoscopy for the management of GI wall defect. Although several endoscopic options are currently used, a standardized evidence-based algorithm for management of GI defect is not available. Successful management of gastrointestinal leaks and fistulae requires a tailored and multidisciplinary approach based on clinical presentation, defect features (size, location and onset time), local expertise and the availability of devices. In this review, we analyze different endoscopic approaches, which we selected on the basis of the available literature and our own experience. Then, we evaluate the overall efficacy and procedural-specific strengths and weaknesses of each approach.

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“…En los casos en los que existan dudas clínicas o con la TC podemos recurrir a estudios gastrointestinales con contraste (tránsito intestinal o enema opaco). Como alternativa en los casos bien establecidos que no existen datos de sepsis asociada, podemos recurrir a fistulografía inyectando contraste hidrosoluble en el trayecto fistuloso a través del orificio externo para descartar que existan tramos de obstrucción intestinal a nivel más distal, pero esta técnica raramente nos permite identificar el origen específico (8) .…”

Section: Introductionunclassified

Experiencia en el manejo de fístulas enterocutáneas postoperatorias en el Hospital Nacional del 2017 al 2022

Echagüe,

Franco López,

Baruja

2024

Rev. Nac. (Itauguá)

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Introducción: la mayoría de las fistulas enterocutáneas se producen como complicación de una o varias cirugías previas. La mortalidad sigue siendo muy elevada. Su tratamiento supone un reto para el cirujano y gran uso de recursos humanos, económicos y prolongada estancia hospitalaria. Objetivo: determinar la experiencia del manejo de las fístulas enterocutáneas postoperatorias en el servicio de cirugía general del Hospital Nacional de Itauguá durante el periodo 2017-2022. Metodología: estudio observacional descriptivo retrospectivo de corte transversal, con muestreo no probabilístico. Solo hubo 30 casos con fichas completas, las cuales sometimos a procesamiento y análisis de las variables de interés. Resultados: de la muestra final 70 % fueron hombres, el promedio de edad fue de 49,6 años y de días de internación 28,6. Solo 5 pacientes consultaron por secreción fecaloide, los demás refirieron secreción seropurulenta por herida o cicatriz operatoria. Del total, 9 fueron de alto débito. El 100 % recibió antibioticoterapia; obitaron 4 de los 14 pacientes intervenidos quirúrgicamente con fin terapéutico. La técnica quirúrgica mayormente utilizada fue: laparotomía + liberación de adherencias e identificación de la fístula + resección intestinal + anastomosis. De los antecedentes la mayoría fueron postoperados de oclusión intestinal mecánica alta o peritonitis aguda de origen apendicular. Conclusión: debido a su alto impacto en la capacidad laboral y social las fístulas enterocutáneas representan patologías quirúrgicas muy complejas y relevantes con bajas tasas de curación definitiva. La mayoría se presentan como complicación de cirugías de urgencia; requiere intervención multidisciplinaria adaptada para cada caso en particular.

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Tratamiento endoscópico de fístulas gastrointestinales con un pegamento biológico tisular

Cited by 13 publications

References 30 publications

Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report

Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report

Endoscopic management of gastrointestinal leaks and fistulae: What option do we have?

Experiencia en el manejo de fístulas enterocutáneas postoperatorias en el Hospital Nacional del 2017 al 2022

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