eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
Current issue Archive Videoforum Manuscripts accepted About the journal Supplements Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank

vol. 12
Case report

Enterocutaneous fistula: a novel video-assisted approach

Hugo Palma Rios, André Goulart, Carla Rolanda, Pedro Leão

Videosurgery Miniinv 2017; 12 (3): 297–300
Online publish date: 2017/05/18
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Video-assisted anal fistula treatment (VAAFT) is a novel minimally invasive and sphincter-saving technique to treat complex anal fistulas described by Meinero in 2006. An enterocutaneous fistula is an abnormal communication between the bowel and the skin. Most cases are secondary to surgical complications, and managing this condition is a true challenge for surgeons. Postoperative fistulas account for 75–85% of all enterocutaneous fistulas. The aim of paper was to devise a minimally invasive technique to treat enterocutaneous fistulas. We used the same principles of VAAFT applied to other conditions, combining endoluminal vision of the tract with colonoscopy to identify the internal opening. We present a case of a 78-year-old woman who was subjected to a total colectomy for cecum and sigmoid synchronous adenocarcinoma. The postoperative course was complicated with an enterocutaneous fistula, treated with conservative measures, which recurred during follow-up. We performed video-assisted fistula treatment using a fistuloscope combined with a colonoscope. Once we identified the fistula tract, we performed cleansing and destruction of the tract, applied synthetic cyanoacrylate and sealed the internal opening with clips through an endoluminal approach. The patient was discharged 5 days later without complications. Two months later the wound was completely healed without evidence of recurrence. This procedure represents an alternative treatment for enterocutaneous fistula using a minimally invasive technique, especially in selected patients not able to undergo major surgery.

mini-invasive endoscopy, enterocutaneous fistula, video-assisted anal fistula treatment

Karvonen JA, Grönroos JM, Nikulainen V, et al. Endoscopic treatment of internal gastrointestinal fistulas with fibrin glue. Surg Laparosc Endosc Percutan Tech 2013; 23: 37-40.
Avalos-González J, Portilla-de Buen E, Leal-Cortés CA, et al. Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant. World J Gastroenterol 2010; 16: 2793-800.
Meinero P, Mori L. Video-assisted anal fistula treatment (VAAFT): a novel sphincter-saving procedure for treating complex anal fistulas. Tech Coloproctol 2011; 15: 417-22.
Bemelman WA, Boermeester, MA. Enterocutaneous fistulas. In: Complexities in Colorectal Surgery. Steele SR, Maykel JA, Champagne BJ, Orangio GR (eds.). Springer, New York 2014; 105-19.
Schecter WP. Management of enterocutaneous fistulas. Surg Clin North Am 2011; 91: 481-91.
Chapman R, Foran R, Dunphy JE. Management of intestinal fistulas. Am J Surg 1964; 108: 157-64.
Schein M. What’s new in postoperative enterocutaneous fistulas? World J Surg 2008; 32: 336-8.
Lloyd DAJ, Gabe SM, Windsor ACJ. Nutrition and management of enterocutaneous fistula. Br J Surg 2006; 93: 1045-55.
Hollington P, Mawdsley J, Lim W, et al. An 11-year experience of enterocutaneous fistula. Br J Surg 2004; 91: 1646-51.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe