Retrospective analysis of the effects of continuous intraluminal aspiration on postoperative intestinal fistulas

Abstract

Aim: The aim of this study was to present the effectiveness of continuous intraluminal aspiration for treating postoperative intestinal fistulas. Methods: Continuous intraluminal aspiration was conducted on nine patients who underwent surgery for upper or lower Gastrointestinal (GI) tract diseases in our General Surgery clinic from January 2014 to March 2016 and developed an intestinal fistula after the surgery. The clinical and demographic results of the patients were analyzed retrospectively. A double-lumen system consisting of a nasogastric catheter and an implanted endoscopic retrograde cholangiopancreatography cannula was used for aspiration. Results: Seven of the nine patients (age range: 28-71 y) were males. Nine patients had complications: six in the upper GI tract and three in the lower GI tract. The first session was technically successful in all patients. Mean hospital stay was 41.77 ± 15.74 d and mean aspiration duration was 14.12 ± 2.84 d. Neoadjuvant chemotherapy (CRT) was performed in four patients. Eight patients recovered and were discharged but one patient, who underwent laparoscopic Ivor Lewis esophagectomy after neoadjuvant CRT for esophageal cancer and developed esophagomediastinal and tracheomediastinal fistulas, died at 20th d after surgery. Clinical success was achieved in five of six patients (83%) who had a fistula and leakage in the upper GI tract, and in three patients (100%) who had a fistula and leakage in the lower GI tract system. Conclusions: Although treatment duration is longer when using continuous intraluminal double-lumen catheter aspiration, it is an effective method to treat postoperative intestinal fistulas with a low mortality rate and cost.