Updates on non-surgical treatments of the enterocutaneous fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xiaoli ^1,2,3 , ZENG Liang ^1,2,3 , SHU Ruo ^1,2,3 , SUN Jiaxue ^1,2,3 , XIONG Pu ^1,2,3 , ZHANG Zunyue ^2,3,4 ,  LUO Huayou ^1,2,3

1. Department of Gastroenterology and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032,P. R. China;
2. Digestive Disease Prevention Engineering Technology Center of Yunnan Province, Kunming 650032, P. R. China;
3. Yunnan Institute of Digestive Diseases, Kunming 650032, P. R. China;
4. Department of Reproductive Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China;

Corresponding author：

LUO Huayou, Email: km-lhy@qq.com

Keywords：

enterocutaneous fistula; fibrin glue; endoscopic treatment; laser ablation; somatostatin; review

DOI：

10.7507/1007-9424.201903021

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective The aim of this paper is to summarize the advantages and disadvantages of non-surgical treatments of the enterocutaneous fistula, in order to give some advice.Methods Pubmed, EMBASE, Medline, CNKI, and Wanfang databases were retrieved for the published article addressing the non-surgical treatments of enterocutaneous fistula between 2004 to 2018. The keywords were " enterocutaneous fistula” in English and Chinese, respectively. The non-surgical treatments of enterocutaneous fistula were reviewed.Results The results of this search suggested that non-surgical treatments of the enterocutaneous fistula mainly include fibrin glue, endoscopic treatment, laser ablation, and somatostatin. Fibrin glue was widely used at domestic and abroad, but it needed repeated operations. Endoscopic treatment of enterocutaneous fistula required a certain professional foundation; laser ablation technology was still immature and required theoretical data support. Now, the use of somatostatin was controversial.Conclusion Each of measures have its advantages and disadvantages, we should determine according to the patient’s condition and economic situation.

Citation： ZHANG Xiaoli, ZENG Liang, SHU Ruo, SUN Jiaxue, XIONG Pu, ZHANG Zunyue, LUO Huayou. Updates on non-surgical treatments of the enterocutaneous fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(9): 1136-1140. doi: 10.7507/1007-9424.201903021 Copy

1.	Islam MS, Gafur MA, Mahmud AA, et al. Clinicopathological study of enterocutaneous fistula in mymensingh medical college hospital. Mymensingh Med J, 2018, 27(3): 513-519.
2.	Ang ZH, Buxey K, Muhlmann M. Novel use of argon plasma coagulation (APC) in the treatment of high output small bowel mucous fistula. Tech Coloproctol, 2018, 22(10): 805-807.
3.	Ramos MFKP, Pereira MA, Barchi LC, et al. Duodenal fistula: the most lethal surgical complication in a case series of radical gastrectomy. Int J Surg, 2018, 53: 366-370.
4.	de Vries FEE, Atema JJ, van Ruler O, et al. A Systematic review and meta-analysis of timing and outcome of intestinal failure surgery in patients with enteric fistula. World J Surg, 2018, 42(3): 695-706.
5.	Adaba F, Vaizey CJ, Warusavitarne J. Management of intestinal failure: the high-output enterostomy and enterocutaneous fistula. Clin Colon Rectal Surg, 2017, 30(3): 215-222.
6.	Hopfner U, Aitzetmueller MM, Neßbach P, et al. Fibrin glue enhances adipose-derived stromal cell cytokine secretion and survival conferring accelerated diabetic wound healing. Stem Cells Int, 2018, 2018: 1353085.
7.	Mizoguchi T, Ueno K, Yanagihara M, et al. Autologous fibroblasts, peripheral blood mononuclear cells, and fibrin glue accelerate healing of refractory cutaneous ulcers in diabetic mice. Am J Transl Res, 2018, 10(9): 2920-2928.
8.	Kowalski C, Kastuar S, Mehta V, et al. Endoscopic injection of fibrin sealant in repair of gastrojejunostomy leak after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis, 2007, 3(4): 438-442.
9.	Chapman BC, Merkow J, Paniccia A, et al. Efficacy of fibrin glue therapy for abscess-associated enteric fistulas. Tech Coloproctol, 2016, 20(9): 641-646.
10.	Lippert E, Klebl FH, Schweller F, et al. Fibrin glue in the endoscopic treatment of fistulae and anastomotic leakages of the gastrointestinal tract. Int J Colorectal Dis, 2011, 26(3): 303-311.
11.	Vitton V, Gasmi M, Barthet M, et al. Long-term healing of Crohn’s anal fistulas with fibrin glue injection. Aliment Pharmacol Ther, 2005, 21(12): 1453-1457.
12.	Nakano Y, Takao T, Morita Y, et al. Endoscopic plombage with polyglycolic acid sheets and fibrin glue for gastrointestinal fistulas. Surg Endosc, 2019, 33(6): 1795-1801.
13.	俞理. 影像技术引导下激光消融治疗肿瘤. 中国介入影像与治疗学, 2011, 8(3): 247-250.
14.	Srinivasa RN, Srinivasa RN, Gemmete JJ, et al. Laser ablation facilitates closure of chronic enterocutaneous fistulae. J Vasc Interv Radiol, 2018, 29(3): 335-339.
15.	Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol, 2011, 15(4): 445-449.
16.	Giamundo P, Geraci M, Tibaldi L, et al. Closure of fistula-in-ano with laser-FiLaC^TM: an effective novel sphincter-saving procedure for complex disease. Colorectal Dis, 2014, 16(2): 110-115.
17.	Wilhelm A, Fiebig A, Krawczak M. Five years of experience with the FiLaC^TM laser for fistula-in-ano management: long-term follow-up from a single institution. Tech Coloproctol, 2017, 21(4): 269-276.
18.	Mönkemüller K, Peter S, Toshniwal J, et al. Multipurpose use of the ‘bear claw’ (over-the-scope-clip system) to treat endoluminal gastrointestinal disorders. Dig Endosc, 2014, 26(3): 350-357.
19.	Lee WC, Ko WJ, Cho JH, et al. Endoscopic treatment of various gastrointestinal tract defects with an over-the-scope clip: case series from a tertiary referral hospital. Clin Endosc, 2014, 47(2): 178-182.
20.	Mercky P, Gonzalez JM, Aimore Bonin E, et al. Usefulness of over-the-scope clipping system for closing digestive fistulas. Dig Endosc, 2015, 27(1): 18-24.
21.	Iabichino G, Eusebi LH, Palamara MA, et al. Performance of the over-the-scope clip system in the endoscopic closure of iatrogenic gastrointestinal perforations and post-surgical leaks and fistulas. Minerva Gastroenterol Dietol, 2018, 64(1): 75-83.
22.	Zeng QS, Wen ZH, Wang QM, et al. Double percutaneous endoscopic gastrostomies for a refractory duodenal fistula. Gastrointest Endosc, 2018, 88(1): 190-192.
23.	Rajan E, Gostout CJ, Aimore Bonin E, et al. Endoscopic full-thickness biopsy of the gastric wall with defect closure by using an endoscopic suturing device: survival porcine study. Gastrointest Endosc, 2012, 76(5): 1014-1019.
24.	Willingham FF, Buscaglia JM. Endoscopic management of gastrointestinal leaks and fistulae. Clin Gastroenterol Hepatol, 2015, 13(10): 1714-1721.
25.	Mukewar S, Kumar N, Catalano M, et al. Safety and efficacy of fistula closure by endoscopic suturing: a multi-center study. Endoscopy, 2016, 48(11): 1023-1028.
26.	Nishizawa T, Akimoto T, Uraoka T, et al. Endoscopic string clip suturing method: a prospective pilot study (with video). Gastrointest Endosc, 2018, 87(4): 1074-1078.
27.	ASGE Technology Committee, Varadarajulu S, Banerjee S, et al. Enteral stents. Gastrointest Endosc, 2011, 74(3): 455-464.
28.	Hünerbein M, Stroszczynski C, Moesta KT, et al. Treatment of thoracic anastomotic leaks after esophagectomy with self-expanding plastic stents. Ann Surg, 2004, 240(5): 801-807.
29.	Huang JJ, Ren JA, Wang GF, et al. 3D-printed " fistula stent” designed for management of enterocutaneous fistula: an advanced strategy. World J Gastroenterol, 2017, 23(41): 7489-7494.
30.	Melich G, Pai A, Balachandran B, et al. Endoscopic control of enterocutaneous fistula by dual intussuscepting stent technique. Surg Endosc, 2016, 30(9): 4150-4151.
31.	Chang J, Sharma G, Boules M, et al. Endoscopic stents in the management of anastomotic complications after foregut surgery: new applications and techniques. Surg Obes Relat Dis, 2016, 12(7): 1373-1381.
32.	Al Lehibi A, Al Balkhi A, Al Mtawa A, et al. Endoscopic biodegradable stents as a rescue treatment in the management of post bariatric surgery leaks: a case series. Endosc Int Open, 2018, 6(6): E722-E726.
33.	de Vries FEE, Reeskamp LF, van Ruler O, et al. Systematic review: pharmacotherapy for high-output enterostomies or enteral fistulas. Aliment Pharmacol Ther, 2017, 46(3): 266-273.
34.	Jamil M, Ahmed U, Sobia H. Role of somatostatin analogues in the management of enterocutaneous fistulae. J Coll Physicians Surg Pak, 2004, 14(4): 237-240.
35.	蔡怀阳, 殷飞. 生长抑素的临床应用进展. 临床荟萃, 2008, 23(20): 1517-1519.
36.	Stevens P, Foulkes RE, Hartford-Beynon JS, et al. Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula. Eur J Gastroenterol Hepatol, 2011, 23(10): 912-922.
37.	Rahbour G, Siddiqui MR, Ullah MR, et al. A meta-analysis of outcomes following use of somatostatin and its analogues for the management of enterocutaneous fistulas. Ann Surg, 2012, 256(6): 946-954.
38.	Coughlin S, Roth L, Lurati G, et al. Somatostatin analogues for the treatment of enterocutaneous fistulas: a systematic review and meta-analysis. World J Surg, 2012, 36(5): 1016-1029.
39.	Parli SE, Pfeifer C, Oyler DR, et al. Redefining " bowel regimen”: pharmacologic strategies and nutritional considerations in the management of small bowel fistulas. Am J Surg, 2018, 216(2): 351-358.
40.	Carrera-Guermeur N, Martín-Crespo RM, Ramírez HJ, et al. Octreotide and enterocutaneous fistula closure in neonates and children. Eur J Pediatr, 2016, 175(3): 305-312.
41.	张朝晖, 曾超, 瞿星光, 等. 大剂量生长抑素联合营养支持治疗肠外瘘的随机对照研究. 广东医学, 2012, 33(13): 2007-2009.

1. Islam MS, Gafur MA, Mahmud AA, et al. Clinicopathological study of enterocutaneous fistula in mymensingh medical college hospital. Mymensingh Med J, 2018, 27(3): 513-519.
2. Ang ZH, Buxey K, Muhlmann M. Novel use of argon plasma coagulation (APC) in the treatment of high output small bowel mucous fistula. Tech Coloproctol, 2018, 22(10): 805-807.
3. Ramos MFKP, Pereira MA, Barchi LC, et al. Duodenal fistula: the most lethal surgical complication in a case series of radical gastrectomy. Int J Surg, 2018, 53: 366-370.
4. de Vries FEE, Atema JJ, van Ruler O, et al. A Systematic review and meta-analysis of timing and outcome of intestinal failure surgery in patients with enteric fistula. World J Surg, 2018, 42(3): 695-706.
5. Adaba F, Vaizey CJ, Warusavitarne J. Management of intestinal failure: the high-output enterostomy and enterocutaneous fistula. Clin Colon Rectal Surg, 2017, 30(3): 215-222.
6. Hopfner U, Aitzetmueller MM, Neßbach P, et al. Fibrin glue enhances adipose-derived stromal cell cytokine secretion and survival conferring accelerated diabetic wound healing. Stem Cells Int, 2018, 2018: 1353085.
7. Mizoguchi T, Ueno K, Yanagihara M, et al. Autologous fibroblasts, peripheral blood mononuclear cells, and fibrin glue accelerate healing of refractory cutaneous ulcers in diabetic mice. Am J Transl Res, 2018, 10(9): 2920-2928.
8. Kowalski C, Kastuar S, Mehta V, et al. Endoscopic injection of fibrin sealant in repair of gastrojejunostomy leak after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis, 2007, 3(4): 438-442.
9. Chapman BC, Merkow J, Paniccia A, et al. Efficacy of fibrin glue therapy for abscess-associated enteric fistulas. Tech Coloproctol, 2016, 20(9): 641-646.
10. Lippert E, Klebl FH, Schweller F, et al. Fibrin glue in the endoscopic treatment of fistulae and anastomotic leakages of the gastrointestinal tract. Int J Colorectal Dis, 2011, 26(3): 303-311.
11. Vitton V, Gasmi M, Barthet M, et al. Long-term healing of Crohn’s anal fistulas with fibrin glue injection. Aliment Pharmacol Ther, 2005, 21(12): 1453-1457.
12. Nakano Y, Takao T, Morita Y, et al. Endoscopic plombage with polyglycolic acid sheets and fibrin glue for gastrointestinal fistulas. Surg Endosc, 2019, 33(6): 1795-1801.
13. 俞理. 影像技术引导下激光消融治疗肿瘤. 中国介入影像与治疗学, 2011, 8(3): 247-250.
14. Srinivasa RN, Srinivasa RN, Gemmete JJ, et al. Laser ablation facilitates closure of chronic enterocutaneous fistulae. J Vasc Interv Radiol, 2018, 29(3): 335-339.
15. Wilhelm A. A new technique for sphincter-preserving anal fistula repair using a novel radial emitting laser probe. Tech Coloproctol, 2011, 15(4): 445-449.
16. Giamundo P, Geraci M, Tibaldi L, et al. Closure of fistula-in-ano with laser-FiLaC^TM: an effective novel sphincter-saving procedure for complex disease. Colorectal Dis, 2014, 16(2): 110-115.
17. Wilhelm A, Fiebig A, Krawczak M. Five years of experience with the FiLaC^TM laser for fistula-in-ano management: long-term follow-up from a single institution. Tech Coloproctol, 2017, 21(4): 269-276.
18. Mönkemüller K, Peter S, Toshniwal J, et al. Multipurpose use of the ‘bear claw’ (over-the-scope-clip system) to treat endoluminal gastrointestinal disorders. Dig Endosc, 2014, 26(3): 350-357.
19. Lee WC, Ko WJ, Cho JH, et al. Endoscopic treatment of various gastrointestinal tract defects with an over-the-scope clip: case series from a tertiary referral hospital. Clin Endosc, 2014, 47(2): 178-182.
20. Mercky P, Gonzalez JM, Aimore Bonin E, et al. Usefulness of over-the-scope clipping system for closing digestive fistulas. Dig Endosc, 2015, 27(1): 18-24.
21. Iabichino G, Eusebi LH, Palamara MA, et al. Performance of the over-the-scope clip system in the endoscopic closure of iatrogenic gastrointestinal perforations and post-surgical leaks and fistulas. Minerva Gastroenterol Dietol, 2018, 64(1): 75-83.
22. Zeng QS, Wen ZH, Wang QM, et al. Double percutaneous endoscopic gastrostomies for a refractory duodenal fistula. Gastrointest Endosc, 2018, 88(1): 190-192.
23. Rajan E, Gostout CJ, Aimore Bonin E, et al. Endoscopic full-thickness biopsy of the gastric wall with defect closure by using an endoscopic suturing device: survival porcine study. Gastrointest Endosc, 2012, 76(5): 1014-1019.
24. Willingham FF, Buscaglia JM. Endoscopic management of gastrointestinal leaks and fistulae. Clin Gastroenterol Hepatol, 2015, 13(10): 1714-1721.
25. Mukewar S, Kumar N, Catalano M, et al. Safety and efficacy of fistula closure by endoscopic suturing: a multi-center study. Endoscopy, 2016, 48(11): 1023-1028.
26. Nishizawa T, Akimoto T, Uraoka T, et al. Endoscopic string clip suturing method: a prospective pilot study (with video). Gastrointest Endosc, 2018, 87(4): 1074-1078.
27. ASGE Technology Committee, Varadarajulu S, Banerjee S, et al. Enteral stents. Gastrointest Endosc, 2011, 74(3): 455-464.
28. Hünerbein M, Stroszczynski C, Moesta KT, et al. Treatment of thoracic anastomotic leaks after esophagectomy with self-expanding plastic stents. Ann Surg, 2004, 240(5): 801-807.
29. Huang JJ, Ren JA, Wang GF, et al. 3D-printed " fistula stent” designed for management of enterocutaneous fistula: an advanced strategy. World J Gastroenterol, 2017, 23(41): 7489-7494.
30. Melich G, Pai A, Balachandran B, et al. Endoscopic control of enterocutaneous fistula by dual intussuscepting stent technique. Surg Endosc, 2016, 30(9): 4150-4151.
31. Chang J, Sharma G, Boules M, et al. Endoscopic stents in the management of anastomotic complications after foregut surgery: new applications and techniques. Surg Obes Relat Dis, 2016, 12(7): 1373-1381.
32. Al Lehibi A, Al Balkhi A, Al Mtawa A, et al. Endoscopic biodegradable stents as a rescue treatment in the management of post bariatric surgery leaks: a case series. Endosc Int Open, 2018, 6(6): E722-E726.
33. de Vries FEE, Reeskamp LF, van Ruler O, et al. Systematic review: pharmacotherapy for high-output enterostomies or enteral fistulas. Aliment Pharmacol Ther, 2017, 46(3): 266-273.
34. Jamil M, Ahmed U, Sobia H. Role of somatostatin analogues in the management of enterocutaneous fistulae. J Coll Physicians Surg Pak, 2004, 14(4): 237-240.
35. 蔡怀阳, 殷飞. 生长抑素的临床应用进展. 临床荟萃, 2008, 23(20): 1517-1519.
36. Stevens P, Foulkes RE, Hartford-Beynon JS, et al. Systematic review and meta-analysis of the role of somatostatin and its analogues in the treatment of enterocutaneous fistula. Eur J Gastroenterol Hepatol, 2011, 23(10): 912-922.
37. Rahbour G, Siddiqui MR, Ullah MR, et al. A meta-analysis of outcomes following use of somatostatin and its analogues for the management of enterocutaneous fistulas. Ann Surg, 2012, 256(6): 946-954.
38. Coughlin S, Roth L, Lurati G, et al. Somatostatin analogues for the treatment of enterocutaneous fistulas: a systematic review and meta-analysis. World J Surg, 2012, 36(5): 1016-1029.
39. Parli SE, Pfeifer C, Oyler DR, et al. Redefining " bowel regimen”: pharmacologic strategies and nutritional considerations in the management of small bowel fistulas. Am J Surg, 2018, 216(2): 351-358.
40. Carrera-Guermeur N, Martín-Crespo RM, Ramírez HJ, et al. Octreotide and enterocutaneous fistula closure in neonates and children. Eur J Pediatr, 2016, 175(3): 305-312.
41. 张朝晖, 曾超, 瞿星光, 等. 大剂量生长抑素联合营养支持治疗肠外瘘的随机对照研究. 广东医学, 2012, 33(13): 2007-2009.

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Updates on non-surgical treatments of the enterocutaneous fistula

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