The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review
Background/purpose: The appropriate management of postoperative upper alimentary tract fistula (UATF) remains uncertain. The efficacy of esophagogastroduodenoscopy (EGD) tissue glue repair in the treatment of patients with postoperative UATF was explored. We also conducted a systematic review of the...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621005866 |
| _version_ | 1818471151716794368 |
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| author | Peng-Sheng Lai Chien-Te Pan Po-Chu Lee I-Rue Lai Chiung-Nien Chen Pei-Ming Huang Ming-Tsan Lin |
| author_facet | Peng-Sheng Lai Chien-Te Pan Po-Chu Lee I-Rue Lai Chiung-Nien Chen Pei-Ming Huang Ming-Tsan Lin |
| author_sort | Peng-Sheng Lai |
| collection | DOAJ |
| description | Background/purpose: The appropriate management of postoperative upper alimentary tract fistula (UATF) remains uncertain. The efficacy of esophagogastroduodenoscopy (EGD) tissue glue repair in the treatment of patients with postoperative UATF was explored. We also conducted a systematic review of the literature regarding the inpatient management of UATF. Methods: Totally 24 patients received EGD tissue glue repair for postoperative UATF at our institute from April 2014 to April 2020. Independent characteristics of size of fistula, location of the UATF, complications, and recurrences were analyzed. PubMed and Cochrane Library databases were reviewed. A pooled analysis was performed, and subgroup analysis was conducted separately for different anatomic locations and techniques. Results: With a mean follow-up of 40 months, the fistula failed to close with EGD tissue glue repair in 2 of 24 patients (8.3%). Eight patients required repeated EGD tissue glue repair, which was more frequent in oral or thoracic UATF (p = 0.053), but all achieved a successful seal in the EGD tissue after glue repair alone (n = 22). The fistula size was correlated with the demand for repeated EGD tissue glue repair (p = 0.017). Besides, a total of 30 studies regarding 2356 cases of postoperative UATF between 2010 and 2021 were retrieved and analyzed. Several non-operative methods were generally accepted as the initial approach, with a non-inferior success rate compared to operative techniques. Conclusion: The results suggest that no single approach toward UATF is superior in terms of success rate and healing time. The potential advantages of EGD tissue glue repair after drainage were more suitable for patients with postoperative UATF and multiple comorbidities. |
| first_indexed | 2024-04-13T21:47:49Z |
| format | Article |
| id | doaj.art-2d4f3b1b229e40e79d33e416e3f392c3 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-13T21:47:49Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-2d4f3b1b229e40e79d33e416e3f392c32022-12-22T02:28:30ZengElsevierJournal of the Formosan Medical Association0929-66462022-07-01121712041214The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic reviewPeng-Sheng Lai0Chien-Te Pan1Po-Chu Lee2I-Rue Lai3Chiung-Nien Chen4Pei-Ming Huang5Ming-Tsan Lin6Department of Surgery, National Taiwan University Hospital Yunlin Branch and National Taiwan University College of Medicine, Taipei, Taiwan; Hepatobiliary Medicine Center, Department of Medicine and Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, TaiwanDepartment of Surgery, National Taiwan University Hospital Yunlin Branch and National Taiwan University College of Medicine, Taipei, Taiwan; Thoracic Medicine Center, Department of Medicine and Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, TaiwanDepartment of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Surgery, National Taiwan University Hospital Yunlin Branch and National Taiwan University College of Medicine, Taipei, Taiwan; Thoracic Medicine Center, Department of Medicine and Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Corresponding author. Department of Surgery, Yunlin Branch, National Taiwan University Hospital and National Taiwan University College of Medicine, New Medical Building- No.579, Sec. 2, Yunlin Rd, Douliou City, Yunlin County 64041, Taiwan.Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanBackground/purpose: The appropriate management of postoperative upper alimentary tract fistula (UATF) remains uncertain. The efficacy of esophagogastroduodenoscopy (EGD) tissue glue repair in the treatment of patients with postoperative UATF was explored. We also conducted a systematic review of the literature regarding the inpatient management of UATF. Methods: Totally 24 patients received EGD tissue glue repair for postoperative UATF at our institute from April 2014 to April 2020. Independent characteristics of size of fistula, location of the UATF, complications, and recurrences were analyzed. PubMed and Cochrane Library databases were reviewed. A pooled analysis was performed, and subgroup analysis was conducted separately for different anatomic locations and techniques. Results: With a mean follow-up of 40 months, the fistula failed to close with EGD tissue glue repair in 2 of 24 patients (8.3%). Eight patients required repeated EGD tissue glue repair, which was more frequent in oral or thoracic UATF (p = 0.053), but all achieved a successful seal in the EGD tissue after glue repair alone (n = 22). The fistula size was correlated with the demand for repeated EGD tissue glue repair (p = 0.017). Besides, a total of 30 studies regarding 2356 cases of postoperative UATF between 2010 and 2021 were retrieved and analyzed. Several non-operative methods were generally accepted as the initial approach, with a non-inferior success rate compared to operative techniques. Conclusion: The results suggest that no single approach toward UATF is superior in terms of success rate and healing time. The potential advantages of EGD tissue glue repair after drainage were more suitable for patients with postoperative UATF and multiple comorbidities.http://www.sciencedirect.com/science/article/pii/S0929664621005866ComplicationEndoscopyFistulaTissue glueUpper alimentary tract |
| spellingShingle | Peng-Sheng Lai Chien-Te Pan Po-Chu Lee I-Rue Lai Chiung-Nien Chen Pei-Ming Huang Ming-Tsan Lin The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review Journal of the Formosan Medical Association Complication Endoscopy Fistula Tissue glue Upper alimentary tract |
| title | The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review |
| title_full | The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review |
| title_fullStr | The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review |
| title_full_unstemmed | The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review |
| title_short | The management of postoperative upper alimentary tract fistulas: A single-center experience of endoscopic tissue glue repair and recommendations of a systematic review |
| title_sort | management of postoperative upper alimentary tract fistulas a single center experience of endoscopic tissue glue repair and recommendations of a systematic review |
| topic | Complication Endoscopy Fistula Tissue glue Upper alimentary tract |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621005866 |
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