肠外瘘的非手术治疗进展

Updates on non-surgical treatments of the enterocutaneous fistula

目的总结各肠外瘘非手术治疗的优缺点,以为肠外瘘的治疗提供参考意见。方法以“enterocutaneous fistula”为英文中文关键词:,以“肠外瘘”为中文中文关键词:,计算机检索Pubmed数据库、EMBASE数据库、Medline数据库、CNKI以及万方数据库2004至2018年期间的有关肠外瘘治疗的文献,就肠外瘘的非手术治疗进行综述。结果肠外瘘的非手术治疗方法主要有凝胶封堵术、内镜治疗、激光消融术以及生长抑素治疗。凝胶封堵技术应用较为广泛,技术在国内外都较为成熟,但是需要反复多次操作;内镜治疗肠外瘘需要术者有一定的专业基础;激光消融技术尚且不成熟,其效果需要数据支持;生长抑素的运用仍存在争议。结论应该根据患者的病情和经济情况决定ECF的治疗方法。

Objective The aim of this paper is to summarize the advantages and disadvantages of non-surgical treatments of the enterocutaneous fistula, in order to give some advice. Methods Pubmed, EMBASE, Medline, CNKI, and Wanfang databases were retrieved for the published article addressing the non-surgical treatments of enterocutaneous fistula between 2004 to 2018. The keywords were "enterocutaneous fistula” in English and Chinese, respectively. The non-surgical treatments of enterocutaneous fistula were reviewed. Results The results of this search suggested that nonsurgical treatments of the enterocutaneous fistula mainly include fibrin glue, endoscopic treatment, laser ablation, and somatostatin. Fibrin glue was widely used at domestic and abroad, but it needed repeated operations. Endoscopic treatment of enterocutaneous fistula required a certain professional foundation;laser ablation technology was still immature and required theoretical data support. Now, the use of somatostatin was controversial. Conclusion Each of measures have its advantages and disadvantages, we should determine according to the patient's condition and economic situation.