Systematized Management of Postoperative Enterocutaneous Fistulas. a 14 Years Experience

AIM: to present a systematized management results, to asses the use of a vacuum system in local treatment and to determine factors influencing the outcome of enterocutaneous (ECF) fistulas. DESIGN: Retrospective, descriptive, observational. METHODS: All patients with postoperative ECF from March 1998 to March 2011 were registered. A management protocol by stages was applied. Demographic aspects, fistula's characteristics and conservative treatment modality were evaluated. Variables were faced with the mortality event using program SPSS version 18. Categorical variables were analyzed using the chi-square or Fisher's exact test when suitable. RESULTS: This study included 125 patients. Fourteen (11.2%) were initially operated, 56 (51.4%) had spontaneous fistula closure only with conservative treatment, whereas 49 patients (44.1%) required reconstructive surgery. Six patients (4.8%) underwent fistula's recurrence and 12 (9.6%) died. Sepsis (p=0,002), multiple fistulas (p=0,024) and abdominal wall defect (p=0,022) were predicting statistically significant mortality factors. CONCLUSIONS: A systematized management of ECF allows to optimizing treatment results. Vacuum therapy was highly effective in output control and provided spontaneous healing in many cases. Sepsis, multiple lesions and abdominal wall defect were negatives prognoses factors.