Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
4279097 | The American Journal of Surgery | 2013 | 6 Pages |
BackgroundThe surgical management of enterocutaneous fistulas (ECFs) in the setting of large abdominal wall defects can be challenging. We aimed to review our experience with simultaneous single-stage ECF takedown and complex abdominal wall reconstruction (AWR).MethodsUsing a prospectively collected database, patients requiring surgical management of an ECF and AWR over a 5-year period were reviewed.ResultsThirty-seven patients (mean age = 58.6 years) underwent ECF repair/AWR. The mean hernia defect size was 426 ± 192 cm2. Thirty-five (95%) patients required fascial releases to achieve abdominal wall closure. Thirty-six (97%) patients had sublay biologic mesh placed to reinforce the repair. Twenty-four (65%) patients developed a surgical site infection (8 superficial, 8 deep, and 8 organ space). Four patients developed an early anastomotic leak/refistulization. With a mean follow-up of 20 months, the hernia recurrence rate was 32% (n = 12).ConclusionsThe simultaneous reconstruction of ECF and complex abdominal wall defects resulted in successful single-stage management of these challenging cases in nearly 70% of patients in this series.