Dis Colon Rectum. 1992 Jul;35(7):635-9. doi: 10.1007/BF02053752.

Treatment of enterocutaneous and colocutaneous fistulas with early surgery or somatostatin analog.

Diseases of the colon and rectum

D I Borison, A D Bloom, T J Pritchard

PMID: 1351835 DOI: 10.1007/BF02053752

Abstract

Standard therapy of enterocutaneous (ECF) and colocutaneous (CCF) fistulas consists of "conservative" management, with surgery reserved for failures of maximal medical treatment. We conducted a five-year retrospective review of 28 patients with low-output ECF and CCF to determine the outcome of early surgical and nonsurgical treatment of these conditions. Twelve men and 16 women with a mean age of 60 years presented with 22 ECF and 6 CCF. Six patients had early operative intervention in an attempt to close their fistulas, while the remaining 22 patients were treated without surgery. In addition, four of the nonsurgical group received parenteral somatostatin analog (SA). None of the surgical patients was septic preoperatively (mean WBC = 9.7), the mean preoperative hospital stay was 11 days, and no patients required a proximal diverting stoma. All of the surgical group resumed normal gastrointestinal function within two weeks, and seven of the nine (78 percent) demonstrated no recurrence of the fistula at a mean follow-up of 8.3 months. Of the 22 medically treated patients, three of the four who received SA healed their fistulas within two weeks. Only two of the other 13 medically treated patients (15 percent) healed their fistulas. Early surgery or the use of SA should be considered in the treatment of patients with low-output intestinal fistulas.

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Substances

• Somatostatin

MeSH terms

• Colonic Diseases / drug therapy
• Colonic Diseases / etiology
• Colonic Diseases / surgery
• Combined Modality Therapy
• Female
• Humans
• Intestinal Fistula / drug therapy
• Intestinal Fistula / etiology
• Intestinal Fistula / surgery
• Male
• Middle Aged
• Postoperative Complications / drug therapy
• Postoperative Complications / surgery
• Retrospective Studies
• Skin Diseases / drug therapy
• Skin Diseases / etiology
• Skin Diseases / surgery
• Somatostatin / analogs & derivatives
• Time Factors
• Wound Healing

Publication Types

• Journal Article

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