Outcomes of simultaneous large complex abdominal wall reconstruction and enterocutaneous fistula takedown - 16/02/13
Corresponding author. Tel.: +1-216-844-2763; fax: +1-216-844-2888.Abstract |
Background |
The surgical management of enterocutaneous fistulas (ECFs) in the setting of large abdominal wall defects can be challenging. We aimed to review our experience with simultaneous single-stage ECF takedown and complex abdominal wall reconstruction (AWR).
Methods |
Using a prospectively collected database, patients requiring surgical management of an ECF and AWR over a 5-year period were reviewed.
Results |
Thirty-seven patients (mean age = 58.6 years) underwent ECF repair/AWR. The mean hernia defect size was 426 ± 192 cm2. Thirty-five (95%) patients required fascial releases to achieve abdominal wall closure. Thirty-six (97%) patients had sublay biologic mesh placed to reinforce the repair. Twenty-four (65%) patients developed a surgical site infection (8 superficial, 8 deep, and 8 organ space). Four patients developed an early anastomotic leak/refistulization. With a mean follow-up of 20 months, the hernia recurrence rate was 32% (n = 12).
Conclusions |
The simultaneous reconstruction of ECF and complex abdominal wall defects resulted in successful single-stage management of these challenging cases in nearly 70% of patients in this series.
Le texte complet de cet article est disponible en PDF.Keywords : Enterocutaneous fistula, Abdominal wall reconstruction, Ventral hernia repair
Plan
| Supported by Lifecell, Davol, W.L. Gore, and Cook. |
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| Dr Novitsky is a speaker for Lifecell and Davol and a consultant for Davol and Kensey Nash. Dr Michael Rosen is a speaker for Lifecell. |
Vol 205 - N° 3
P. 354-359 - mars 2013 Retour au numéro
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