Abstract
Background: a fecal stula is dreadful complication both for patients ,surgeons and care takers after the major abdominal surgery. though rarely encountered but very challenging as the chance of operability and future healing always remains a question in surgeon's mind and sigh of relief isn't possible until patients starts tolerating oral feeds. A conservative management option always hit the surgeon's mind, the same idea has been evaluated here in detail. the objective was to analyze and check the Objectives: effectiveness of conservative management option of fecal stula in our patients and to which extent it is viable to adhere it in patients. We have choose some parameters to assess it which has been described later. Patients and Methods: In this study, a comparative study was done about evaluation of total gut irrigation method for the closure of fecal stula. The total 40 patients over the period of 2 years were included in the study and 20 patients were divided in each group, in one group we had given the total gut irrigation and in another group we did not give any gut irrigation. We evaluated the both groups on following parameters.1. spontaneous closure of fecal stula 2. Skin conditions 3. Time to start the oral feed 4. Days of hospitalization 5. Development of features of intestinal obstruction 6. Sepsis in patients. Results: In this study we found that for the low output stula and some selective cases of medium output stula, the TGI is good and attractive option, though the statistical test doesn't show difference on some points mentioned above but in half of the parameters they were signicant. In high output stula group we found not much usability of TGI but in previous two types there was clear positive difference on almost all parameters. Total gut Conclusion: irrigation(TGI) is a simple and an important bedside test whose methodology when applied to acute fecal stula helps to characterize the stula from a functional aspect. In our study of 40 patients we found the clear mandate of TGI in low output and selective medium output stula
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