Managements Of Enterocutaneous Fistula (ECF)

Abstract

Background:- A fistula is an abnormal epithelialized tract Between two or Hollow organ to Another hollow organ or to the skin.
It is estimated that 90% of ECF arise after surgical procedures, The mortality rate about 37% in post-operative high output ECF.
Objectives:-The aim of present study to evaluate the standardized Guideline And prognostic factors for outcome of patients with ECF.
Patients &Methods:- A prospective clinical trial conducted from January 2002-July 2013. done in the surgical ward of Al-Yarmouk Teaching Hospital.
In this study a database was created consisting of 115 patients with ECF. All have Been treated according to the SOWATS guideline, which consists of the following Components, Sepsis, Optimization of nutritional state , Wound care, Anatomy of Fistula,Timing of surgery and Surgical strategy.
Results :- Data from 115 patients. Mean age 42 year(range from 8-76 year).
Postoperative fistula after initial surgery for any reason appeared after mean 20 day (range from 3-37 day). The mean length of hospital stay was 57 day(range from 8-106 day). Mean period of treatment was 80 day(range from 10-150day).
Conclusion:- The main lesson to be learned is that adherence to SOWATS Guideline can result in good patient outcome. Surgical repair is performed when the Patient is stable. Treatment of sepsis plays a key role and ongoing sepsis is still the Most important cause of death.