title: Digestive system fistula: a problem still relevant today.
abstract: Digestive system fistula originates most frequently as a complication after surgical procedures, less often occurs in the course of inflammatory diseases, but it can also result from neoplasm and injuries. THE AIM OF THE STUDY was to analyze the causes and retrospectively assess the perioperative procedures as well as the results of digestive system fistula treatment. MATERIAL AND METHODS. Own experience in digestive system fistula treatment was presented. The subject group consisted of 32 patients treated at the General Surgery, Oncology and Endocrinology Clinical Department between 01.05.2005 and 30.04.2010 due to different digestive tract diseases. The causes of the occurrence of digestive system fistula, methods and results of treatment were analyzed. RESULTS. The analysis covered 32 patients with digestive system fistula, among them 15 men and 17 women. Average age for men was 57 years (20-78), and for women 61 years (24-88). In 11 patients idiopathic fistula causally connected with primary inflammatory disease (7 cases) and with neoplasm (4 cases) was diagnosed, in 19 patients fistula was the result of complications after surgery, in 2 - after abdominal cavity injury. Recovery from fistula was achieved in 23 patients (72%) with the use of individually planned conservative therapy (TPN, EN, antibiotics, drainage, and others) and surgery, depending on the needs of individual patient. 5 patients (16%) died, whereas in 4 left (12%) recovery wasn't achieved (fistula in palliative patients, with advanced stages of neoplasm - bronchoesophageal fistula, the recurrence of uterine carcinoma). CONCLUSIONS. Recently the results of digestive system fistula treatment showed an improvement which manifests itself in mortality decrease and shortening of fistula healing time. Yet, digestive system fistula as a serious complication still poses a very difficult surgical problem.
authors.affiliation: Clinical Division of General, Oncological and Endocrinological Surgery Provincial Hospital in Kielce.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Głuszek
authors.forename: Maria
authors.initials: M
authors.lastname: Korczak
authors.forename: Marta
authors.initials: M
authors.lastname: Kot
authors.forename: Jarosław
authors.initials: J
authors.lastname: Matykiewicz
authors.forename: Dorota
authors.initials: D
authors.lastname: Kozieł
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015984:Causality; D015897:Comorbidity; D016154:Digestive System Fistula / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D004322:Drainage / Q000379:methods; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents