Treatment of 27 postoperative enterocutaneous fistulas with the long half-life somatostatin analogue SMS 201-995.
Twenty-seven patients with postoperative enterocutaneous fistulas were treated with parenteral nutrition and SMS 201-995 (100 micrograms/8 hours, subcutaneously), a long half-life somatostatin analogue. At the time SMS 201-995 was started, 11 patients had low output fistulas (less than 1000 ml/48 hours), 11 patients had high output fistulas (above 1000 ml/48 hours), and 5 patients had fistulas sitting in large abdominal wall defects. Within 24 hours of treatment, a mean reduction of 55% of the fistula output was observed. Fistula site or output before treatment had no influence on the magnitude of output reduction. Spontaneous closure was achieved in 77% of the patients after a mean of 5.8 +/- 2.7 days of treatment with this drug. Two patients died (7.4%). Pain at the injection site was referred by 15% of the patients but no other side effects were observed. Glucose intolerance was not observed. SMS 201-995 has been shown to be very useful in the conservative treatment of enterocutaneous fistulas because of its ability to rapidly reduce fistula output and accelerate spontaneous closure.
Nubiola
P
P
Department of Surgery, Hospital del Mar, Barcelona, Spain.
Badia
J M
JM
Martinez-Rodenas
F
F
Gil
M J
MJ
Segura
M
M
Sancho
J
J
Sitges-Serra
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D005402:Fistula / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007412:Intestinal Fistula / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010288:Parenteral Nutrition; D011183:Postoperative Complications / Q000188:drug therapy* / Q000628:therapy; D011897:Random Allocation; D012871:Skin Diseases / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy
D015282:Octreotide