Giovanni Mauri1,2, Lorenzo C Pescatori3, Chiara Mattiuz3, Dario Poretti4, Vittorio Pedicini4, Fabio Melchiorre5, Umberto Rossi6, Luigi Solbiati7, Luca Maria Sconfienza8,9. 1. Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. vanni.mauri@gmail.com. 2. Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy. vanni.mauri@gmail.com. 3. Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy. 4. Department of Radiology, Humanitas Research Hospital, Rozzano, 20089, Milan, Italy. 5. Department of Radiology, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy. 6. Division of Radiology and Interventional Radiology, Department of Diagnostic Sciences, San Carlo Borromeo Hospital, Via Pio II 3, 20153, Milan, Italy. 7. Humanitas University, Rozzano, 20089, Milan, Italy. 8. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy. 9. Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
Abstract
OBJECTIVES: To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments. METHODS: Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection. RESULTS: In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient. CONCLUSIONS: Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.
OBJECTIVES: To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments. METHODS: Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection. RESULTS: In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient. CONCLUSIONS: Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.
Authors: G Mauri; L M Sconfienza; B Fiore; G Brambilla; V Pedicini; D Poretti; R F Lutman; M Montorsi; F Sardanelli Journal: Clin Radiol Date: 2012-05-19 Impact factor: 2.350