Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study
Duodenal stump fistula (DSF) is a serious complication of radical gastrectomy for gastric cancer. Herein, we illustrated an innovative choice for treating duodenal stump fistulas by placing a modified sump drainage through trocar puncture into the DSF-related abscess (DSF-abscess) cavity. We retrosp...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Surgery Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845023000775 |
| _version_ | 1797398572722814976 |
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| author | Xiao-Tong Wang Han-Qing Ya Long Wang Huan-Huan Chen Yan-Fei Zhang Xiao-Hong Luo Lei Li Fan-Biao Kong Xiao-Gang Zhong Wei Mai |
| author_facet | Xiao-Tong Wang Han-Qing Ya Long Wang Huan-Huan Chen Yan-Fei Zhang Xiao-Hong Luo Lei Li Fan-Biao Kong Xiao-Gang Zhong Wei Mai |
| author_sort | Xiao-Tong Wang |
| collection | DOAJ |
| description | Duodenal stump fistula (DSF) is a serious complication of radical gastrectomy for gastric cancer. Herein, we illustrated an innovative choice for treating duodenal stump fistulas by placing a modified sump drainage through trocar puncture into the DSF-related abscess (DSF-abscess) cavity. We retrospectively analyzed 974 consecutive patients who underwent gastrectomy for gastric cancer between 2011 and 2021. Of these patients, 34 who developed postoperative duodenal stump fistulas postoperatively were enrolled into our study, and their clinical data were retrospectively assessed. From January 2011 to December 2017, 15 patients received conventional treatments (percutaneous catheter drainage, PCD group) known as the traditional percutaneous method, and 19 patients from January 2018 to December 2021 received new treatments (Troca's SD group) consisting of conventional therapies and placement of a modified sump drainage through trocar puncture into DSF-abscess cavity. The demographics, clinical characteristics and treatment outcomes were compared between two groups. Compared with the PCD group, the rates of postoperative complications, duodenostomy creation, subsequent surgery, fistula healing rates of the DSF, and length of postoperative hospital stay were significantly decreased in the Troca SD group. However, there was no significant difference in the abscess recurrence rate and mortality rates. Trocar puncture with a modified sump drainage is an safe, effective, and technically feasible treatment for duodenal stump fistula after radical gastrectomy for gastric cancer. This novel technique should be further investigated using large-scale RCT research. |
| first_indexed | 2024-03-09T01:27:25Z |
| format | Article |
| id | doaj.art-8627a90471824ddc8f6dbd0177682174 |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-03-09T01:27:25Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-8627a90471824ddc8f6dbd01776821742023-12-10T06:17:04ZengElsevierSurgery Open Science2589-84502023-12-0116121126Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled studyXiao-Tong Wang0Han-Qing Ya1Long Wang2Huan-Huan Chen3Yan-Fei Zhang4Xiao-Hong Luo5Lei Li6Fan-Biao Kong7Xiao-Gang Zhong8Wei Mai9Departments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of ChinaDepartments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of ChinaDepartments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of ChinaDepartments of Colorectum and Anus Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of ChinaDepartments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of ChinaDepartments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of ChinaDepartments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China; Corresponding authors.Departments of Colorectum and Anus Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China; Corresponding authors.Departments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China; Corresponding authors.Departments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Guangxi Academy of Medical Sciences, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China; Corresponding authors.Duodenal stump fistula (DSF) is a serious complication of radical gastrectomy for gastric cancer. Herein, we illustrated an innovative choice for treating duodenal stump fistulas by placing a modified sump drainage through trocar puncture into the DSF-related abscess (DSF-abscess) cavity. We retrospectively analyzed 974 consecutive patients who underwent gastrectomy for gastric cancer between 2011 and 2021. Of these patients, 34 who developed postoperative duodenal stump fistulas postoperatively were enrolled into our study, and their clinical data were retrospectively assessed. From January 2011 to December 2017, 15 patients received conventional treatments (percutaneous catheter drainage, PCD group) known as the traditional percutaneous method, and 19 patients from January 2018 to December 2021 received new treatments (Troca's SD group) consisting of conventional therapies and placement of a modified sump drainage through trocar puncture into DSF-abscess cavity. The demographics, clinical characteristics and treatment outcomes were compared between two groups. Compared with the PCD group, the rates of postoperative complications, duodenostomy creation, subsequent surgery, fistula healing rates of the DSF, and length of postoperative hospital stay were significantly decreased in the Troca SD group. However, there was no significant difference in the abscess recurrence rate and mortality rates. Trocar puncture with a modified sump drainage is an safe, effective, and technically feasible treatment for duodenal stump fistula after radical gastrectomy for gastric cancer. This novel technique should be further investigated using large-scale RCT research.http://www.sciencedirect.com/science/article/pii/S2589845023000775Duodenal stump fistulaModified sump drainageRadical gastrectomyGastric cancerTrocar puncture |
| spellingShingle | Xiao-Tong Wang Han-Qing Ya Long Wang Huan-Huan Chen Yan-Fei Zhang Xiao-Hong Luo Lei Li Fan-Biao Kong Xiao-Gang Zhong Wei Mai Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study Surgery Open Science Duodenal stump fistula Modified sump drainage Radical gastrectomy Gastric cancer Trocar puncture |
| title | Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study |
| title_full | Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study |
| title_fullStr | Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study |
| title_full_unstemmed | Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study |
| title_short | Trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer: A retrospective controlled study |
| title_sort | trocar puncture with modified sump drainage for duodenal stump fistula after radical gastrectomy for gastric cancer a retrospective controlled study |
| topic | Duodenal stump fistula Modified sump drainage Radical gastrectomy Gastric cancer Trocar puncture |
| url | http://www.sciencedirect.com/science/article/pii/S2589845023000775 |
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