Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2025; 17(3): 101076
Published online Mar 15, 2025. doi: 10.4251/wjgo.v17.i3.101076
Retrospective analysis of factors influencing the self-healing of patients with enterocutaneous fistulas receiving conservative treatment
Zhuo-Nan Zhuang, Rui Zhao, Yuan-Xin Li
Zhuo-Nan Zhuang, Yuan-Xin Li, Department of Gastrointestinal, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Rui Zhao, Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Co-first authors: Zhuo-Nan Zhuang and Rui Zhao.
Author contributions: Zhuang ZN and Zhao R collected the clinical data and wrote the paper; and Li YX designed the report.
Institutional review board statement: The patient data used in this study were reviewed and approved by the hospital ethics committee.
Informed consent statement: The patient privacy was protected. All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data collected during the study are available from the first author by request: Zhuo-Nan Zhuang, E-mail: zhuangzhuonan1984@163.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Xin Li, MD, PhD, Chief Physician, Department of Gastrointestinal, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Tiantongyuan, Litanglu Road, Changping District, Beijing 102218, China. liyuanxin1966@163.com
Received: September 3, 2024
Revised: December 9, 2024
Accepted: January 17, 2025
Published online: March 15, 2025
Processing time: 163 Days and 19.4 Hours
Abstract
BACKGROUND

Enterocutaneous (EC) fistula incidence has been increasing in China, along with increases in the volume and complexity of surgeries. The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.

AIM

To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing. These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.

METHODS

The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected. The relationships between the cure rate and characteristics such as age, sex, body mass index, albumin level, primary disease, cause of the fistula, location of the fistula, number of fistulas, nature of the fistula, infection status, diagnostic methods, nutritional support methods, somatostatin therapy, growth hormone therapy, and fibrin glue therapy were analyzed.

RESULTS

A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease (P = 0.044), location of the fistula (P = 0.006), number of fistulas (P = 0.007), and use of adhesive sealing (χ2 = 12.194, P < 0.001) between the uncured and cured groups. The use of fibrin glue was a significant factor associated with a cure for fistulas (odds ratio = 5.459, 95%CI: 1.958-15.219, P = 0.01).

CONCLUSION

The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.

Keywords: Enterocutaneous fistula; Conservative treatment; Fibrin glue; Fistula sealing; Cure rate

Core Tip: Enterocutaneous (EC) fistulas can cause various complications, such as infections, fluid loss, internal homeostasis imbalance, organ dysfunction, malnutrition, and other changes. This study aimed to improve treatment outcomes for patients with EC fistulas and reduce the need for reoperation. The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.