Efficacy of over-the-scope clip for gastrointestinal fistula / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the efficacy of over-the-scope clip (OTSC) in the treatment of gastrointestinal fistula.</p><p><b>METHODS</b>Clinical data of 12 gastrointestinal fistula patients, including 3 internal fistula and 9 external fistula treated with OTSC in our institute from March 2015 to May 2016 were retrospectively analyzed. OTSC was performed when pus was drained thoroughly and intra-abdominal infection around gastrointestinal fistula was controlled, and each patient received one clip to close fistula.</p><p><b>RESULTS</b>There were 6 female and 6 male patients with mean age of (50.1±12.6) years. The successful rate of endoscopic closure was 100% without complications including bleeding and intestinal obstruction during and after OTSC treatment. According to comprehensive evaluation, including drainage without digestive juices, no recurrence of intra-abdominal infection, no overflow of contrast medium during digestive tract radiography, and CT examination without intra-abdominal abscess, clinical gastrointestinal fistula closure was 91.7%(11/12). There was no recurrence of gastrointestinal fistula during 3 months of follow-up in 11 patients. In the remaining 1 case, the gastric fistula after laparoscopic sleeve gastrectomy recurred one week after OTSC treatment because of intra-abdominal infection surrounding fistula, and was cured by surgery finally.</p><p><b>CONCLUSION</b>The endoscopic closure treatment of OTSC for gastrointestinal fistula is successful and effective, and control of intra-abdominal infection around fistula with adequate drainage is the key point.</p>

Fast track surgery preoperative preparation / 肠外与肠内营养

Recovery after surgery can be substantially facilitated by taking fast track surgery.Preoperative patient preparation is the beginning of the fast-track surgery,and it will influence the course of patient care after the operation.Preoperative patient preparation of the fast-track surgery was reviewed.