Management of Enteroatmospheric Fistula using the Flexiseal® System.
Silvia Carbonell-Morote1, Juan Jesús Rubio1, Ester Gracia1, Emilio Ruiz de la Cuesta1, José Manuel Ramia1,2. Rifat Latifi
1Department of Surgery. Hospital General Universitario Dr. Balmis. Alicante (Spain)
2Miguel Hernández University. Alicante (Spain)
Corresponding author:
Silvia Carbonell Morote
Calle José Llopis Diez nº2, 1-B, 03015, Alicante
Teléfono: 620417184
Mail: [email protected]
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Abstract
Introduction: Enterocutaneous fistula (ECF) and enteroatmospheric fistula (EAF) remain sources of considerable morbidity and mortality. Diverting intestinal content is essential for patient optimization before definitive treatment in managing ECF/EAF. Here, we describe a modified innovative technique for effluent control using Flexi-Seal® Fecal Management System (FMS®) in a highly complex ECF/EAF.
Patient and Methods: Male, 56 years old. After performing several abdominal surgeries. The patient had a complex uncontrolled EAF/ECF that was not solved, although we tried varied methods.
Results: The most proximal fistulous orifice was identified manually in the operating room, and the FMS® tube was introduced into the intestinal lumen. We obtained a clear improvement after controlling intestinal discharges. So, we were able to perform a small bowel resection and close the abdominal wall. Postoperative evolution was favorable, and the patient was discharged 92 days after admission.
Conclusion: Our technique using the FMS® device serves as a valuable tool for effluent control in patients presenting with complex ECF/EAF. It is clinically effective and less labor-intensive than other methods. It should not perhaps be used as the first option but should be kept in mind for complex fistulas treated unsuccessfully with other methods.
Keywords: enteroatmospheric fistula, enterocutaneous fistula, acute care, surgery