title: Enterocutaneous fistula: analysis of clinical outcomes from a single Victorian tertiary referral centre.
abstract: BACKGROUND
  Enterocutaneous fistulas (ECFs) are complex and can result in significant morbidity and mortality. The study aimed to evaluate ECF outcomes in a single tertiary hospital.
  
  
  METHODS
  A retrospective study of all patients treated with ECF between the period of January 2009 and June 2014 was conducted. Baseline demographic data assessed included the primary aetiology of the fistula, site of the fistula and output of the fistula. Outcomes measures assessed included re-fistulation rate, return to theatre, wound complications, fistula closure rate and death over the study period.
  
  
  RESULTS
  A total of 16 patients with ECF were recorded within the study period. Mean age of the patient cohort was 55.8 ± 11.8 years with a female predominance (11 females, 5 males). Primary aetiology were Crohn's disease (31%), post intra-abdominal surgery not related to bowel neoplasia (50%) and post intra-abdominal surgery related to bowel neoplasia (19%). Majority of the fistulas developed from the small bowel (75%) and had low output (63%). Operative intervention was required in 81% of patients with an overall closure rate of 100%. Median operations required for successful closure was 1.15 operations. Mean duration between index operation and curative operation was 8 ± 12.7 months.
  
  
  CONCLUSIONS
  Appropriate bundle of care (perioperative care, surgical timing and surgical technique) can produce excellent results in patients with ECF.
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Yit J
authors.initials: YJ
authors.lastname: Leang
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Bell
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Carne
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Martin
authors.initials: M
authors.lastname: Chin
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Chip
authors.initials: C
authors.lastname: Farmer
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Steward
authors.initials: S
authors.lastname: Skinner
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Wale
authors.affiliation: Department of Colorectal Surgery, Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Satish K
authors.initials: SK
authors.lastname: Warrier
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D003424:Crohn Disease / Q000150:complications; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: colorectal surgery; enterocutaneous; fistula; outcome