22 July 2019 : Clinical Research
Med Sci Monit 2019; 25:5445-5452
BACKGROUND: Definitive surgical repair of persistent fistulas of the small intestine remains a surgical challenge with a high rate of re-fistulation and mortality. The aim of this study was to evaluate the type and incidence of complications after definitive surgical repair, and to identify factors predictive of severe postoperative complications or fistula recurrence.
MATERIAL AND METHODS: This was a retrospective study of 42 patients who underwent elective surgical repair of a persistent fistula of the small intestine. The analysis included preoperative and intraoperative parameters.
RESULTS: The healing rate after definitive surgery was 71.4%. Postoperative complications developed in 88.1% of patients. The mortality rate was 7.2%. Fistula recurrence was recognized in 21.4% of cases. Overall, 93 complications occurred in 37 patients. The most common complications were septic (48.0%). Hemorrhagic and digestive tract-related complications accounted for 19.0% and 15.0% of all complications, respectively. Severe complications (Clavien-Dindo grade III–V) made up 28.0% of all complications. In univariate analysis, multiple fistulas (p=0.03), higher C-reactive protein level (p=0.01), and longer time interval from admission to definitive surgery (p=0.01) were associated with an increased risk of severe complications or fistula recurrence. In multivariate analysis, only multiple fistulas were an independent risk factor for severe complications or fistula recurrence (OR=8.2, p=0.04).
CONCLUSIONS: Fistula complexity determines the risk of severe postoperative complications or fistula recurrence after definitive surgical repair of the persistent small intestine fistulas. Inflammatory parameters should be normalized before definitive surgery.
Keywords: Digestive System Surgical Procedures, Intestinal Fistula, Postoperative Complications, Risk Factors
01 December 2021 : EditorialEditorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19
Med Sci Monit 2021; 27:e935624
03 December 2021 : Laboratory ResearchInfluenza and Influenza-Like Respiratory Virus Infections in Children During the 2019/20 Influenza Season a...
Med Sci Monit In Press; DOI: 10.12659/MSM.934862
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
01 November 2021 : EditorialEditorial: What Can be Learned from National and International Vaccine Adverse Event Reporting Systems Duri...
Med Sci Monit 2022; 28:e935299
07 Dec 2021 : Review articleA Review of the Impact of Neutrophils and Neutrophil Extracellular Traps (NETs) on the Development of Aorti...
Med Sci Monit In Press; DOI: 10.12659/MSM.935134
07 Dec 2021 : Review articleAdie’s Pupil: A Diagnostic Challenge for the Physician
Med Sci Monit In Press; DOI: 10.12659/MSM.934657
06 Dec 2021 : Animal ResearchAstragalus Flavone Induces Proliferation and Differentiation of Neural Stem Cells in a Cerebral Infarction ...
Med Sci Monit In Press; DOI: 10.12659/MSM.933830
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700