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Outcomes of simultaneous large complex abdominal wall reconstruction and enterocutaneous fistula takedown

Outcomes of simultaneous large complex abdominal wall reconstruction and enterocutaneous fistula takedown

American Journal of Surgery 205(3): 354-8; Discussion 358-9

The surgical management of enterocutaneous fistulas (ECFs) in the setting of large abdominal wall defects can be challenging. We aimed to review our experience with simultaneous single-stage ECF takedown and complex abdominal wall reconstruction (AWR). Using a prospectively collected database, patients requiring surgical management of an ECF and AWR over a 5-year period were reviewed. Thirty-seven patients (mean age = 58.6 years) underwent ECF repair/AWR. The mean hernia defect size was 426 ± 192 cm(2). Thirty-five (95%) patients required fascial releases to achieve abdominal wall closure. Thirty-six (97%) patients had sublay biologic mesh placed to reinforce the repair. Twenty-four (65%) patients developed a surgical site infection (8 superficial, 8 deep, and 8 organ space). Four patients developed an early anastomotic leak/refistulization. With a mean follow-up of 20 months, the hernia recurrence rate was 32% (n = 12). The simultaneous reconstruction of ECF and complex abdominal wall defects resulted in successful single-stage management of these challenging cases in nearly 70% of patients in this series.

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Accession: 036750008

Download citation: RISBibTeXText

PMID: 23375762

DOI: 10.1016/j.amjsurg.2012.10.013

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