ABSTRACT
BACKGROUND: Surgical management of gastrointestinal fistulae has been reported to carry a 30-day morbidity rate up to 82% and a mortality rate ranging from 2% to 4.8%; thus nonoperative alternatives are required. The aim of the present study was to assess the current experience on the use of cyanoacrylates in the management of these fistulae. METHODS: A systematic review was carried out on Medline, Embase, The Cochrane database, Academic Search Complete, MedicLatina, and SciELO for English, Spanish, and Portuguese articles dealing with refractory fistulae by means of cyanoacrylate embolization therapy. Publication dates were restricted from 1969 to present. Outcome parameters were study design, number of participants, etiology of the fistula, approach, material used, success rate, complications, and mortality. RESULTS: Electronic search yielded a total of 377 articles. After a meticulous screening, only 14 studies dealing with foregut/midgut fistulae and 6 addressing hindgut fistulae were included. All the included articles were prospective and retrospective case series. Cumulative success rate was 81% (range 0% to 100%) and 3 out of 203 patients (1%) developed minor complications. CONCLUSION: Cyanoacrylate embolization of nearly all types of refractory gastrointestinal fistulae is a feasible and harmless technique. Prospective controlled studies are required to support the available evidence.
Subject(s)
Cyanoacrylates , Embolization, Therapeutic/methods , Gastric Fistula/therapy , Intestinal Fistula/therapy , Tissue Adhesives , Cyanoacrylates/adverse effects , Cyanoacrylates/therapeutic use , Humans , Tissue Adhesives/adverse effects , Tissue Adhesives/therapeutic useABSTRACT
El granuloma central de células gigantes es una patología poco común que constituye el7% de las lesiones benignas de los maxilares. Se trata de un proceso osteolítico localizado, de naturaleza variablemente agresiva, que aparece con mayor frecuencia en los sectores anteriores de los maxilares en niños y adolescentes jóvenes. Su etiología es aún un tema de gran controversia y constituye el 1% de las lesiones óseas tumorales. Se presenta el caso de un paciente varón de48 años de edad con una lesión indolora en la región hemimaxilar superior derecha, que engloba las piezas 16, 17 y 18 con movilidad en el 16. En la ortopantomografía, se advierte una gran lesión osteolítica, y se realiza un primer diagnóstico de presunción de quiste de origen odontogénico, por lo que se (..) (AU)
The central giant-cell granuloma is an uncommon pathology that constitutes 7% of the benign lesions of the maxilla. It deals with a localised osteolytic process, of a variably aggressive nature, that appears with greater frequency in the anterior sectors of the maxilla in children and young adolescents. Its aetiology is still a subject of great controversy and it constitutes 1% of the osseous tumour lesions. The case is presented of a male patient of48 years of age with a painless lesion in the upper right hemimaxilla region, which includes the pieces 16, 17 and 18 with mobility in the 16. The orthopantomograph warned of a large osteolytic lesion, and a primary diagnosis was made of the presumption of a cyst ofodontogenic origin, for which reason it was removed. During the surgery, a mass was observed not compatible with a cyst and an (..) (AU)
