The Experts below are selected from a list of 1023 Experts worldwide ranked by ideXlab platform

A J Windsor - One of the best experts on this subject based on the ideXlab platform.

  • nutrition and management of Enterocutaneous Fistula
    British Journal of Surgery, 2006
    Co-Authors: David A J Lloyd, S M Gabe, A J Windsor
    Abstract:

    Background: The management of Enterocutaneous Fistula is challenging, with significant associated morbidity and mortality. This article reviews treatment, with emphasis on the provision and optimal route of nutritional support. Methods: Relevant articles were identified using Medline searches. Secondary articles were identified from the reference lists of key papers. Results and conclusion: Management of Enterocutaneous Fistula should initially concentrate on correction of fluid and electrolyte imbalances, drainage of collections, treatment of sepsis and control of Fistula output. The routine use of somatostatin infusion and somatostatin analogues remains controversial; although there are data suggesting reduced time to Fistula closure, there is little evidence of increased probability of spontaneous closure. Malnutrition is common and adequate nutritional provision is essential, enteral where possible, although supplemental parenteral nutrition is often required for high-output small bowel Fistulas. The role of immunonutrition is unknown. Surgical repair should be attempted when spontaneous Fistula closure does not occur, but it should be delayed for at least 3m onths.

  • an 11 year experience of Enterocutaneous Fistula
    British Journal of Surgery, 2004
    Co-Authors: Paul Hollington, S M Gabe, J Mawdsley, W Lim, Alastair Forbes, A J Windsor
    Abstract:

    Background: Enterocutaneous Fistula has traditionally been associated with substantial morbidity and mortality, related to fluid, electrolyte and metabolic disturbance, sepsis and malnutrition. Methods: A retrospective review of Enterocutaneous Fistula in 277 consecutive patients treated over an 11-year period in a major tertiary referral centre was undertaken to evaluate current management practice and outcome. Results: Most Fistulas occurred secondary to abdominal surgery, and a high proportion (52·7 per cent) occurred in association with inflammatory bowel disease. A low rate of spontaneous healing was observed (19·9 per cent). The healing rate after definitive Fistula surgery was 82·0 per cent, although more than one attempt was required to achieve surgical closure in some patients. Definitive Fistula resection resulted in a mortality rate of 3·0 per cent. In addition, one patient died after laparotomy for intra-abdominal sepsis and an additional 24 patients died from complications of Fistulation, giving an overall Fistula-related mortality rate of 10·8 per cent. Conclusion: Early recognition and control of sepsis, management of fluid and electrolyte imbalances, meticulous wound care and nutritional support appear to reduce the mortality rate, and allow spontaneous Fistula closure in some patients. Definitive surgical management is performed only after restitution of normal physiology, usually after at least 6 months. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  • an 11 year experience of Enterocutaneous Fistula
    Royal Australasian College of Surgeons Annual Scientific Congress, 2004
    Co-Authors: Paul Hollington, S M Gabe, J Mawdsley, W Lim, Alastair Forbes, A J Windsor
    Abstract:

    Background: Enterocutaneous Fistula has traditionally been associated with substantial morbidity and mortality, related to fluid, electrolyte and metabolic disturbance, sepsis and malnutrition. Methods: A retrospective review of Enterocutaneous Fistula in 277 consecutive patients treated over an 11-year period in a major tertiary referral centre was undertaken to evaluate current management practice and outcome. Results: Most Fistulas occurred secondary to abdominal surgery, and a high proportion (52.7 per cent) occurred in association with inflammatory bowel disease. A low rate of spontaneous healing was observed (19.9 per cent). The healing rate after definitive Fistula surgery was 82.0 per cent, although more than one attempt was required to achieve surgical closure in some patients. Definitive Fistula resection resulted in a mortality rate of 3.0 per cent. In addition, one patient died after laparotomy for intra-abdominal sepsis and an additional 24 patients died from complications ofFistulation, giving an overall Fistula-related mortality rate of 10.8 per cent. Conclusion: Early recognition and control of sepsis, management of fluid and electrolyte imbalances, meticulous wound care and nutritional support appear to reduce the mortality rate, and allow spontaneous Fistula closure in some patients. Definitive surgical management is performed only after restitution of normal physiology, usually after at least 6 months.

Denis Picot - One of the best experts on this subject based on the ideXlab platform.

  • Chyme reinfusion or enteroclysis in nutrition of patients with temporary double enterostomy or Enterocutaneous Fistula
    Current Opinion in Clinical Nutrition and Metabolic Care, 2016
    Co-Authors: Ronan Thibault, Denis Picot
    Abstract:

    Purpose of review: Patients with double temporary enterostomy or Enterocutaneous Fistula may suffer from intestinal failure. Parenteral nutrition is the gold standard treatment until surgical re-establishment of intestinal continuity, but serious complications may arise. Chyme reinfusion or enteroclysis are indicated. Recent findings: Chyme reinfusion corrects the intestinal failure by restoring intestinal absorption, allowing parenteral nutrition weaning in 91% of patients. Chyme reinfusion contributes to improve nutritional status and reduce plasma liver test abnormalities. Chyme reinfusion is feasible at home without any serious complications in selected patients. Mechanisms underlying chyme reinfusion effectiveness on intestinal function, such as restoration of ileal brake, are suggested but most remain to be demonstrated. When the downstream small bowel is exposed, enteroclysis of enteral nutrition or hydration could be helpful to reduce parenteral nutrition needs, or in case of insufficient food intake during chyme reinfusion. Summary: Chyme reinfusion or enteroclysis are less expensive, well tolerated, and easy-to-use nutrition support techniques, which may allow reducing parenteral nutrition-related healthcare costs. The latter remains to be demonstrated in the setting of a prospective randomized controlled trial. This review may contribute to improve the awareness of intensivists, digestive surgeons, and gastroenterologists involved in intestinal failure management to spread the use of chyme reinfusion or enteroclysis.

Wifanto Saditya Jeo - One of the best experts on this subject based on the ideXlab platform.

  • spontaneous closure of multiple Enterocutaneous Fistula due to abdominal tuberculosis using negative pressure wound therapy a case report
    Journal of Surgical Case Reports, 2018
    Co-Authors: Yuliardy Limengka, Wifanto Saditya Jeo
    Abstract:

    Enterocutaneous Fistula (ECF) is one of the most challenging abdominal complications, for surgeons and other healthcare members, which involves significant morbidity and potentially mortality. Despite advancements in both operative and non-operative therapy, Fistula-related complications are still unavoidable. Negative pressure wound therapy (NPWT) had been used years to treat chronic wound, to decrease tissue edema, improve circulation, promote healthy granulation tissue and inhibit bacterial growth. We report a 29-year-old male with complicated ECF due to abdominal tuberculosis, that was healed after treated using NPWT. This was the first ECF patient in our hospital treated using NPWT.

Mark A Carlson - One of the best experts on this subject based on the ideXlab platform.

  • Enterocutaneous Fistula associated with eptfe mesh case report and review of the literature
    Hernia, 2009
    Co-Authors: M Foda, Mark A Carlson
    Abstract:

    A case of Enterocutaneous Fistula secondary to the erosion of an expanded polytetrafluoroethylene (ePTFE) prosthesis into the jejunum is described. This case is unusual secondary to the long experience with ePTFE and the lack of published cases similar to this one. The technical details of this case reveal extenuating circumstances associated with the Fistula formation, and it is concluded that this particular case does not provide sufficient evidence to implicate ePTFE, by itself, as an etiologic agent for gastrointestinal fistulization. In addition, the published safety record of ePTFE in abdominal wall surgery is reviewed.

H J Bonjer - One of the best experts on this subject based on the ideXlab platform.

  • intraperitoneal polypropylene mesh repair of incisional hernia is not associated with Enterocutaneous Fistula
    British Journal of Surgery, 2002
    Co-Authors: W W Vrijland, J Jeekel, Ewout W Steyerberg, P Den T Hoed, H J Bonjer
    Abstract:

    Background: Incisional hernia repair with prosthetic material is followed by fewer recurrences than primary repair. Polypropylene is the most commonly used prosthetic material but may cause Enterocutaneous Fistulas. The aim of this study was to determine whether Enterocutaneous Fistulas developed after incisional hernia repair with polypropylene mesh and to evaluate clinical outcome after incisional hernia repair. Methods: A retrospective analysis of the outcome of incisional hernia repair with polypropylene mesh between 1982 and 1998 was conducted. Follow-up data were obtained from medical records and questionnaires. Results: Polypropylene incisional hernia repair was performed in 136 patients. Median follow-up was 34 months. No Enterocutaneous Fistulas developed. Wound infection occurred in 6 per cent. Wound sinus formation occurred in two patients. No mesh was removed because of infection and no persisting infection of the mesh occurred. Conclusion: Enterocutaneous Fistula formation appears to be very rare after incisional hernia repair with polypropylene mesh, regardless of intraperitoneal placement, omental coverage or closing of the peritoneum.