BACKGROUND: Despite of advances obtained today, the enterocutaneous fistula has a mortality rate from 25 to 50%. The presence of cancer increases death frequency and makes difficult its treatment. OBJECTIVE: Evaluate the results of management of enterocutaneous fistula in cancer patients. METHODS: Seventy six cancer patients with average age of 56.8 +/- 13.5 years old and received curative primary treatment for malignancy at the Oncology Hospital, National Medical Center in Mexico who developed an enterocutaneous fistula between 1992 and 2002 were studied. RESULTS: Resolution of fistula was obtained in 52 patients (68.4%). Among these 52, 41 fistulae (53.9%) resolved spontaneously, and 11 required surgical treatment. All patients were treated with parenteral nutrition and octreotide. The meantime to fistula resolution, in those patients whose fistula was spontaneously resolved, was 20 days. Among the 24 patients who died, 21 had sepsis. Fistula-related mortality was highest in those patients with postoperative origin (82%; p = 0.024), of high output (57%; p = 0.001) and ileum site (45%; p = 0.04). CONCLUSIONS: The spontaneous closure is high and the surgical treatment is the best option. The mortality rate is moderate and sepsis the most frequent cause of death.
BACKGROUND: Despite of advances obtained today, the enterocutaneous fistula has a mortality rate from 25 to 50%. The presence of cancer increases death frequency and makes difficult its treatment. OBJECTIVE: Evaluate the results of management of enterocutaneous fistula in cancerpatients. METHODS: Seventy six cancerpatients with average age of 56.8 +/- 13.5 years old and received curative primary treatment for malignancy at the Oncology Hospital, National Medical Center in Mexico who developed an enterocutaneous fistula between 1992 and 2002 were studied. RESULTS: Resolution of fistula was obtained in 52 patients (68.4%). Among these 52, 41 fistulae (53.9%) resolved spontaneously, and 11 required surgical treatment. All patients were treated with parenteral nutrition and octreotide. The meantime to fistula resolution, in those patients whose fistula was spontaneously resolved, was 20 days. Among the 24 patients who died, 21 had sepsis. Fistula-related mortality was highest in those patients with postoperative origin (82%; p = 0.024), of high output (57%; p = 0.001) and ileum site (45%; p = 0.04). CONCLUSIONS: The spontaneous closure is high and the surgical treatment is the best option. The mortality rate is moderate and sepsis the most frequent cause of death.