Endoscopic purse-string suture and naso-jejunal tube feeding for duodenal cutaneous fistula and gastric cutaneous fistula.

Duodenal cutaneous fistula Endoscopic purse-string suture Gastric cutaneous fistula Naso-jejunal tube feeding

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
06 Oct 2024
Historique:
received: 02 04 2024
accepted: 13 09 2024
medline: 6 10 2024
pubmed: 6 10 2024
entrez: 6 10 2024
Statut: aheadofprint

Résumé

The Endoscopic Purse-string Suture (EPSS) technique has gained attention for its potential in closing large defects following gastrointestinal procedures. However, its application in fistula closure is not as widely reported. This study aims to evaluate the safety and efficacy of EPSS and naso-jejunal tube feeding in the closure of duodenal cutaneous fistulas and gastric cutaneous fistulas. This single-center retrospective study, conducted from September 2020 to September 2023 at Tongji University in Shanghai, China, examined the outcomes of EPPS and nasojejunal feeding for patients with gastric and duodenal cutaneous fistulas (n = 10). Demographic data, fistula characteristics, procedure technique and outcomes were evaluated. In this study, the average size of a fistula opening was 7.9 ± 4.6 mm. The operations took an average of 25.8 ± 5.6 min. Patients typically needed naso-jejunal tube feeding for a median of 14.0 days, with an interquartile range (IQR) of 7.7-19.0 days. The median duration of hospital stay post-operation was 16.5 days, with an IQR of 7.0-25.0 days. Nine patients were successful in their initial fistula closure using the EPSS technique. The other patient underwent a second EPSS and, ultimately, all patients experienced complete healing and fully recovered. There were no major adverse events reported. EPSS and naso-jejunal tube feeding are a safe and effective treatment option for duodenal and gastric cutaneous fistulas. Larger, prospective studies are needed to validate these findings and establish the long-term safety and efficacy of this approach.

Sections du résumé

BACKGROUND BACKGROUND
The Endoscopic Purse-string Suture (EPSS) technique has gained attention for its potential in closing large defects following gastrointestinal procedures. However, its application in fistula closure is not as widely reported. This study aims to evaluate the safety and efficacy of EPSS and naso-jejunal tube feeding in the closure of duodenal cutaneous fistulas and gastric cutaneous fistulas.
METHODS METHODS
This single-center retrospective study, conducted from September 2020 to September 2023 at Tongji University in Shanghai, China, examined the outcomes of EPPS and nasojejunal feeding for patients with gastric and duodenal cutaneous fistulas (n = 10). Demographic data, fistula characteristics, procedure technique and outcomes were evaluated.
RESULTS RESULTS
In this study, the average size of a fistula opening was 7.9 ± 4.6 mm. The operations took an average of 25.8 ± 5.6 min. Patients typically needed naso-jejunal tube feeding for a median of 14.0 days, with an interquartile range (IQR) of 7.7-19.0 days. The median duration of hospital stay post-operation was 16.5 days, with an IQR of 7.0-25.0 days. Nine patients were successful in their initial fistula closure using the EPSS technique. The other patient underwent a second EPSS and, ultimately, all patients experienced complete healing and fully recovered. There were no major adverse events reported.
CONCLUSIONS CONCLUSIONS
EPSS and naso-jejunal tube feeding are a safe and effective treatment option for duodenal and gastric cutaneous fistulas. Larger, prospective studies are needed to validate these findings and establish the long-term safety and efficacy of this approach.

Identifiants

DOI: 10.1007/s00464-024-11281-0 PMID: 39369376
pubmed: 39369376
doi: 10.1007/s00464-024-11281-0
pii: 10.1007/s00464-024-11281-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : excellent young physician training program of Shanghai Tenth People's Hospital
ID : 2018SYPDRC043

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Xiaocai Wu (X)

Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Maochun Tang (M)

Digestive Endoscopy Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Xiaojia Hou (X)

Digestive Endoscopy Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Sinthu Kosasih (S)

Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Renyuan Gao (R)

Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Tianqi Wu (T)

Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Lu Yin (L)

Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China.

Chunqiu Chen (C)

Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China. chenchunqiu6@126.com.

Feng Liu (F)

Digestive Endoscopy Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301, Yanchang Road, Shanghai, 200072, China. drliuffeng@hotmail.com.

Classifications MeSH