Alternative surgical treatment for complex enterocutaneous fistula

A retrospective analysis on the clinical-surgical handling of patients with enterocutaneous fistula (ECF) was performed, where an alternative surgical technique was discussed: intestinal bypass. Fistula with draining over 500 ml/24 h,which were present in 13 patients, were classified as high debit. We defined as complex, the fistula with multiple orifices, high defect of t he abdominal wall or through the mesh. The population studied consisted of 25 patients, 11 male, in a total of 34 ECF and mean age of 41.9 years. At c linical treatment with TPN for high debit ECF, 2 patients (16.6%) were cure d, another 2 died and 8 (66.8%) needed surgical treatment. The surgery cure d 7 patients (77.7%) with high debit ECF but 2 (22.3%) died. In the patient s with low debit ECF, TPN cured 2 patients (40%) but failed in another 3 (6 0%). All patients with low debit ECF resolved with surgical treatment.