[Postoperative esophageal-visceral fistulae: their prevention and treatment].
A series of 12 cases of esophageal anastomotic leakage following esophageal surgery observed from 1969 to 1989 is retrospectively analyzed. In the period 1969-1975 6 patients were treated in emergency and the mortality rate was 66.6%, while the remaining 6 patients observed from 1975 to 1989 were treated conservatively with total parenteral nutrition (sometimes associating adequate surgical drainage): the mortality rate was 16.6%. In conclusion, not only in the treatment of anastomotic leakage, but also in its prevention, artificial nutrition has a crucial role. The outcome of thoracic and abdominal fistulas depends mainly on adequate drainage, not necessarily surgical. Cervical fistulas heal in 2-4 weeks, but strictures arise frequently and respond to endoscopic dilatation.
Simi
M
M
II Clinica Chirurgica Generale e Terapia Chirurgia, Università degli Studi La Sapienza, Roma.
Schietroma
M
M
Minervini
S
S
Aloisio
F
F
Leardi
S
S
Recchia
C L
CL
Muzi
F
F
Di Marco
R
R
Speranza
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition; D004937:Esophageal Fistula / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies; D014781:Viscera
Fistole esofago-viscerali postoperatorie: prevenzione e trattamento.