THE ROLE OF FISTULOCLYSIS IN THE TREATMENT OF PATIENTS WITH ENTEROATMOSPHERIC FISTULAS

Marcelo Augusto Fontenelle Ribeiro-Junior, Daniel Dante Yeh, Samara de Souza Augusto, Yasmin Garcia Batista Elias, Paola Rezende Néder, Cássia Tiemi Kawase Costa, Andressa Daniel Maurício, Salomone Di Saverio

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Enterocutaneous fistulas represent a connection between the gastrointestinal tract and adjacent tissues. Among them, there is a subdivision - the enteroatmospheric fistulas, in which the origin is the gastrointestinal tract in connection with the external environment through an open wound in the abdomen. Due to the high output in enterocutaneous fistulas, the loss of fluids, electrolytes, minerals and proteins leads to complications such as sepsis, malnutrition and electrolyte derangements. The parenteral nutrition has its secondary risks, and the fistuloclysis, that consist in the infusion of enteral feeding and also the chyme through the distal fistula, represents an alternative to the management of these patients until the definitive surgical approach. AIM: To evaluate the current evidence on the fistuloclysis technique, its applicability, advantages and disadvantages for patients with high output fistulas. METHOD: A systematic literature search was conducted in May 2020 with the headings "fistuloclysis", "chyme reinfusion" and "succus entericus reinfusion", in the PubMed, Medline and SciELO databases. Results: There were 29 articles selected for the development of this narrative synthesis, from 2003 to 2020, including reviews and case reports. CONCLUSION: Fistuloclysis is a safe method which optimizes the clinical, nutritional, and immunological conditions of patients with enteroatmospheric fistulas, increasing the chances of success of the reconstructive procedure. In cases where the definitive repair is not possible, chances of reducing or even stopping the use of nutrition through the parental route are increased, thus representing a promising modality for the management of most challenging cases.

Original languageEnglish (US)
Pages (from-to)e1605
JournalArquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery
Volume34
Issue number2
DOIs
StatePublished - 2021

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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