title: Surgery for high-output small bowel enterocutaneous fistula: a 30-year experience.
abstract: The outcome of surgery undertaken to repair high-output small bowel enterocutaneous fistula (SBECF) using the same technique was evaluated. Of a total of 282 patients with a high-output SBECF (daily fistula output > 500 ml), 183 patients were managed conservatively; in this group, a spontaneous closure rate of 81.4% (n = 149) and a mortality rate of 18.6% (n = 34) was noted. Ninety-nine patients (35.1%) underwent definitive surgical treatment. In all patients, after resection of the fistula, the entire small bowel was stented. Six patients (6%) died in the postoperative period. No complications developed as a result of intestinal stenting. Including the patients treated successfully for postoperative persistence of fistula, surgical repair was successful in 93 patients (93.9%). No patients returned with refistulization or small bowel obstruction within 6 months of surgery. We believe that routine intraluminal stenting should be an integral component of the surgical technique for the repair of SBECF.
authors.affiliation: Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa. singhb3@ukzn.ac.za
authors.forename: B
authors.initials: B
authors.lastname: Singh
authors.forename: A A
authors.initials: AA
authors.lastname: Haffejee
authors.forename: L
authors.initials: L
authors.lastname: Allopi
authors.forename: J
authors.initials: J
authors.lastname: Moodley
mesh_terms: D000293:Adolescent; D000328:Adult; D017577:Cutaneous Fistula / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome