2.50
Hdl Handle:
http://hdl.handle.net/10541/86651
Title:
The staged management of complex entero-urinary fistulae.
Authors:
Shackley, David C; Brew, C J; Bryden, A A; Anderson, I D; Carlson, G L; Scott, N A; Clarke, Noel W ( 0000-0001-7776-8059 )
Abstract:
OBJECTIVE: To present the results of the staged management of complex entero-urinary fistulae. PATIENTS AND METHODS: Ten patients with complex entero-urinary fistulae were reviewed; all patients were referred to a national intestinal failure unit after failed treatment in other centres. Each patient was treated in three stages. The acute stage involved proximal defunctioning and distal drainage of both the gastrointestinal and urinary tracts to isolate the fistula, together with the eradication of sepsis. The recovery stage involved total parenteral nutrition, organ support, radiological planning of surgical reconstruction and intensive nursing. The reconstructive stage followed when the patient was stable, nutritionally replenished and intra-abdominal sepsis was controlled. Surgery was undertaken jointly by urological and gastrointestinal surgeons. RESULTS: The fistulae were treated successfully in all patients, with functional restoration in four, and/or diversion of the gastrointestinal and urological tracts in six. The mean (range) time to reconstruction was 5 (1-20) months. There were no postoperative deaths. CONCLUSION: A staged multidisciplinary approach with delayed reconstruction can achieve a successful outcome in the management of complex entero-urinary fistulae.
Affiliation:
Department of Urological Surgery, and Intestinal Failure Unit, Hope Hospital, Salford Royal Hospitals Trust, Salford, UK. dshackley@picr.man.ac.uk
Citation:
The staged management of complex entero-urinary fistulae. 2000, 86 (6):624-9 BJU Int.
Journal:
BJU International
Issue Date:
Oct-2000
URI:
http://hdl.handle.net/10541/86651
DOI:
10.1046/j.1464-410x.2000.00871.x
PubMed ID:
11069366
Type:
Article
Language:
en
ISSN:
1464-4096
Appears in Collections:
All Christie Publications ; All Paterson Institute for Cancer Research

Full metadata record

DC FieldValue Language
dc.contributor.authorShackley, David Cen
dc.contributor.authorBrew, C Jen
dc.contributor.authorBryden, A Aen
dc.contributor.authorAnderson, I Den
dc.contributor.authorCarlson, G Len
dc.contributor.authorScott, N Aen
dc.contributor.authorClarke, Noel Wen
dc.date.accessioned2009-11-23T10:28:57Z-
dc.date.available2009-11-23T10:28:57Z-
dc.date.issued2000-10-
dc.identifier.citationThe staged management of complex entero-urinary fistulae. 2000, 86 (6):624-9 BJU Int.en
dc.identifier.issn1464-4096-
dc.identifier.pmid11069366-
dc.identifier.doi10.1046/j.1464-410x.2000.00871.x-
dc.identifier.urihttp://hdl.handle.net/10541/86651-
dc.description.abstractOBJECTIVE: To present the results of the staged management of complex entero-urinary fistulae. PATIENTS AND METHODS: Ten patients with complex entero-urinary fistulae were reviewed; all patients were referred to a national intestinal failure unit after failed treatment in other centres. Each patient was treated in three stages. The acute stage involved proximal defunctioning and distal drainage of both the gastrointestinal and urinary tracts to isolate the fistula, together with the eradication of sepsis. The recovery stage involved total parenteral nutrition, organ support, radiological planning of surgical reconstruction and intensive nursing. The reconstructive stage followed when the patient was stable, nutritionally replenished and intra-abdominal sepsis was controlled. Surgery was undertaken jointly by urological and gastrointestinal surgeons. RESULTS: The fistulae were treated successfully in all patients, with functional restoration in four, and/or diversion of the gastrointestinal and urological tracts in six. The mean (range) time to reconstruction was 5 (1-20) months. There were no postoperative deaths. CONCLUSION: A staged multidisciplinary approach with delayed reconstruction can achieve a successful outcome in the management of complex entero-urinary fistulae.en
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIntestinal Fistula-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPatient Care Team-
dc.subject.meshReconstructive Surgical Procedures-
dc.subject.meshSepsis-
dc.subject.meshSurgical Flaps-
dc.subject.meshTreatment Outcome-
dc.subject.meshUrinary Fistula-
dc.titleThe staged management of complex entero-urinary fistulae.en
dc.typeArticleen
dc.contributor.departmentDepartment of Urological Surgery, and Intestinal Failure Unit, Hope Hospital, Salford Royal Hospitals Trust, Salford, UK. dshackley@picr.man.ac.uken
dc.identifier.journalBJU Internationalen

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