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dc.contributor.authorShackley, David C
dc.contributor.authorBrew, C J
dc.contributor.authorBryden, A A
dc.contributor.authorAnderson, I D
dc.contributor.authorCarlson, G L
dc.contributor.authorScott, N A
dc.contributor.authorClarke, Noel W
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.
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
html.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.


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