Palliative surgical treatment in enterocutaneous fistula

✍ Scribed by Zografos, George C.; Peros, George; Androulakis, George

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 40 KB
• Volume: 66
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(199710)66:2<138::aid-jso13>3.0.co;2-#

✦ Synopsis

Advanced, recurrent vascular lower abdominal or pelvic tumors following abdominoperineal resection causing enterocutaneous fistulas, particularly after radiotherapy, present a difficult clinical problem [1]. When a radical resection is technically not possible, or dissection of the segment of small bowel adherent to the recurrent tumor and connected to the fistula is inadvisable, control of the fistula can be obtained by the following method.

First, the afferent and efferent loops are dissected. The adherent loop and the mesentery providing its blood supply are preserved. The involved bowel segment is divided proximal and distal to the fistula by using a stapling device, or manually, and is left behind in its position (Fig. 1). Finally, intestinal continuity is reconstructed by means of an end-to-end anastomosis (Fig. 2).