Retrospective analysis of factors influencing the self-healing of patients with enterocutaneous fistulas receiving conservative treatment

回顾性分析影响接受保守治疗的肠瘘患者自愈的因素

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Abstract

BACKGROUND: Enterocutaneous (EC) fistula incidence has been increasing in China, along with increases in the volume and complexity of surgeries. The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation. AIM: To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing. These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment. METHODS: The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected. The relationships between the cure rate and characteristics such as age, sex, body mass index, albumin level, primary disease, cause of the fistula, location of the fistula, number of fistulas, nature of the fistula, infection status, diagnostic methods, nutritional support methods, somatostatin therapy, growth hormone therapy, and fibrin glue therapy were analyzed. RESULTS: A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease (P = 0.044), location of the fistula (P = 0.006), number of fistulas (P = 0.007), and use of adhesive sealing (χ (2) = 12.194, P < 0.001) between the uncured and cured groups. The use of fibrin glue was a significant factor associated with a cure for fistulas (odds ratio = 5.459, 95%CI: 1.958-15.219, P = 0.01). CONCLUSION: The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.

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