Endo-luminal Graft Exclusion for Enteroatmospheric Fistulae

Author(s):
Gefei Wang; Jianan Ren

Background:

It remains an extreme challenge in clinical practice to manage the enteroatmospheric fistula (EAF) which is a severe complication of open abdomen, and herein we report “Endo-luminal Graft Exclusion” technique to control EAF.

Hypothesis:

We designed an innovative “Endo-luminal Graft Exclusion” technique for avoiding loss of enteric fistula effluent from EAF, protecting open abdominal wounds from being contaminated by intestinal fistulae drainages, and applying enteral nutrition.

Methods:

“Endo-luminal Graft Exclusion” technique with “fistula patch” or 3D-printed “fistula stent” was designed and applied in 30 EAFs, from Jan 2010 to Sep 2017.

Results:

30 patients were successfully treated by the “Endo-luminal Graft Exclusion” technique including 25 patients with “fistula patch” and 5 patients with 3D-printed “fistula stent”, and all patients ultimately achieved enteroatmospheric fistula excision and abdominal wound closure.

Conclusions:

The “Endo-luminal Graft Exclusion” technique with “fistula patch” or 3D-printed “fistula stent” is effective methods to control EAF, because it can avoid loss of enteric fistula effluent, cease tissue destruction, simplify wound management, and perform enteral nutrition followed by definitive operation to resect EAF and repair ventral hernia.