An alternative negative pressure treatment for enteroatmospheric fistula resulting from small intestinal leakage caused by incision dehiscence

Ran Sun; Xin Xu; Shikun Luo; Risheng Zhao; Weiliang Tian; Ming Huang; Zheng Yao

doi:10.1016/j.heliyon.2023.e22045

An alternative negative pressure treatment for enteroatmospheric fistula resulting from small intestinal leakage caused by incision dehiscence

Heliyon. 2023 Nov 4;9(11):e22045. doi: 10.1016/j.heliyon.2023.e22045. eCollection 2023 Nov.

Authors

Ran Sun¹, Xin Xu², Shikun Luo², Risheng Zhao², Weiliang Tian¹, Ming Huang², Zheng Yao²

Affiliations

¹ Department of General Surgery, Jinling Hospital, Nanjing, Jiangsu, China.
² Department of General Surgery, Jiangning Hospital, Nanjing, Jiangsu, China.

Abstract

Background: To investigate the efficacy of an alternative negative pressure treatment for the treatment of enteroatmospheric fistula transformed from small intestinal leakage due to incision dehiscence after abdominal surgery.

Methods: Patients with an enteroatmospheric fistula from small intestinal leakage owing to incision dehiscence following abdominal surgery between January 2010 and December 2019 were retrospectively reviewed.

Results: A total of 83 patients (mean age: 38.3 ± 11.6 years; Body mass index: 19.9 ± 2.2 kg/m²) were enrolled. Of the 83 patients, 59 (71.1 %) achieved fistula closure. High-output fistula (Hazard ratio = 0.48; 95 % Confidence interval: 0.29-0.81; P = 0.006) and abdominal wall thickness >2 cm (Hazard ratio = 2.76; 95 % Confidence interval: 1.35-5.67; P = 0.006) were identified as factors affecting fistula closure. Lastly, 11/83 (13.3 %) patients exhibited re-dehiscence.

Conclusion: Appropriately applying the alternative negative pressure treatment may enable fistula closure in patients with enteroatmospheric fistula resulting from small intestinal leakage caused by incision dehiscence.

Keywords: Enteroatmospheric fistula; Infections; Outcomes; Surgery; Treatment.