BACKGROUND: Traditionally treatment of aorto-enteric fistulae involved placement of an extra-anatomic bypass and graft excision. This is associated with limb loss (10-40%) and high mortality (10-70%). More recently in situ revascularisation has been advocated. AIMS: To examine our experience with the changing management of aorto-enteric fistulae over a 22-year period. METHODS: Demographic, clinical, operative and pathological data were recorded retrospectively. RESULTS: Twenty-one patients were included. Seven had primary fistulae. Six died prior to intervention. Five had an extra-anatomical bypass (60% mortality, 40% limb loss), four had in-situ revascularisation (25% mortality), four had a primary repair (25% mortality) and two had insertion of a tube graft (primary fistulae). The overall survival rate was 38%. The postoperative survival rate was 6o%. CONCLUSION: Techniques for operative management continue to evolve. The current trend is towards a local surgical approach with prolonged and intensive postoperative antimicrobial therapy. In our experience this approach has yielded acceptable outcomes.
BACKGROUND: Traditionally treatment of aorto-enteric fistulae involved placement of an extra-anatomic bypass and graft excision. This is associated with limb loss (10-40%) and high mortality (10-70%). More recently in situ revascularisation has been advocated. AIMS: To examine our experience with the changing management of aorto-enteric fistulae over a 22-year period. METHODS: Demographic, clinical, operative and pathological data were recorded retrospectively. RESULTS: Twenty-one patients were included. Seven had primary fistulae. Six died prior to intervention. Five had an extra-anatomical bypass (60% mortality, 40% limb loss), four had in-situ revascularisation (25% mortality), four had a primary repair (25% mortality) and two had insertion of a tube graft (primary fistulae). The overall survival rate was 38%. The postoperative survival rate was 6o%. CONCLUSION: Techniques for operative management continue to evolve. The current trend is towards a local surgical approach with prolonged and intensive postoperative antimicrobial therapy. In our experience this approach has yielded acceptable outcomes.
Authors: C H Antinori; C T Andrew; J S Santaspirt; D T Villanueva; J A Kuchler; M L deLeon; W C Cody; D J DiPaola; V J Manuele Journal: Am Surg Date: 1996-05 Impact factor: 0.688
Authors: R Chiesa; D Astore; S Frigerio; L Garriboli; G Piccolo; R Castellano; M Scalamogna; A Odero; S Pirrelli; G Biasi; P Mingazzini; P Biglioli; G Polvani; A Guarino; G Agrifoglio; A Tori; G Spina Journal: Acta Chir Belg Date: 2002-08 Impact factor: 1.090
Authors: Francisco S Lozano; Luis Muñoz-Bellvis; Enrique San Norberto; Asuncion Garcia-Plaza; Jose Ramon Gonzalez-Porras Journal: J Gastrointest Surg Date: 2008-02-27 Impact factor: 3.452