title: [A novel treatment strategy using trafermin, containing basic fibroblast growth factor, for intractable duodenal fistula following curative gastrectomy for gastric cancer-case report and literature review].
abstract: Despite recent perioperative technological advances in gastric cancer treatment, duodenal stump leakage and intractable duodenal fistula are still major critical complications following gastrectomy that should be specifically targeted in order to improve postoperative outcomes. Here, we provide a preliminary report of a case of intractable duodenal fistula successfully treated with Trafermin containing basic fibroblast growth factor. A 70-year-old man underwent distal gastrectomy with radical lymphadenectomy for early distal gastric cancer (pT1bN0M0). After surgery, duodenal fistula occurred and persisted for 1 year and 2 months despite surgery and several conservative treatments. After obtaining informed consent, we started injection of Trafermin at 50 μg/day through a drainage tube into the dehiscence of the duodenum. Consequently, the duodenal fistula was successfully closed within 4 weeks. Our novel treatment technique is simple, rapid, and cost effective. If informed consent is obtained from patients with a low risk of recurrence, this technique should be recommended as one of the treatment choices for intractable duodenal fistula following curative gastrectomy for gastric cancer.
authors.affiliation: Dept. of Surgery, Kyoto Prefectural University of Medicine, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takemoto
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D004378:Duodenal Diseases / Q000188:drug therapy*; D016222:Fibroblast Growth Factor 2 / Q000627:therapeutic use*; D005346:Fibroblast Growth Factors / Q000627:therapeutic use*; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007412:Intestinal Fistula / Q000188:drug therapy*; D008297:Male; D019300:Medical Errors; D010446:Peptide Fragments / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: D010446:Peptide Fragments; D016222:Fibroblast Growth Factor 2; C114444:trafermin; D005346:Fibroblast Growth Factors