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TitleEnterocutaneous fistula: a novel video-assisted approach
Author(s)Rios, Hugo Palma
Goulart, André
Rolanda, Carla
Teixeira, Pedro Alexandre Leão Araújo Gonçalves
KeywordsMini-invasive endoscopy
Enterocutaneous fistula
Video-assisted anal fistula treatment
Issue date6-Sep-2017
PublisherTermedia Publishing
JournalVideosurgery and Other Miniinvasive Techniques
CitationRios, H. P., Goulart, A., Rolanda, C., & Leão, P. (2017). Enterocutaneous fistula: a novel video-assisted approach. Videosurgery and Other Miniinvasive Techniques, 12(3), 297
Abstract(s)Video-assisted anal fistula treatment (VAAFT) is a novel minimally invasive and sphincter-saving technique to treat complex anal fistulas described by Meinero in 2006. An enterocutaneous fistula is an abnormal communication between the bowel and the skin. Most cases are secondary to surgical complications, and managing this condition is a true challenge for surgeons. Postoperative fistulas account for 75-85% of all enterocutaneous fistulas. The aim of paper was to devise a minimally invasive technique to treat enterocutaneous fistulas. We used the same principles of VAAFT applied to other conditions, combining endoluminal vision of the tract with colonoscopy to identify the internal opening. We present a case of a 78-year-old woman who was subjected to a total colectomy for cecum and sigmoid synchronous adenocarcinoma. The postoperative course was complicated with an enterocutaneous fistula, treated with conservative measures, which recurred during follow-up. We performed video-assisted fistula treatment using a fistuloscope combined with a colonoscope. Once we identified the fistula tract, we performed cleansing and destruction of the tract, applied synthetic cyanoacrylate and sealed the internal opening with clips through an endoluminal approach. The patient was discharged 5 days later without complications. Two months later the wound was completely healed without evidence of recurrence. This procedure represents an alternative treatment for enterocutaneous fistula using a minimally invasive technique, especially in selected patients not able to undergo major surgery.
Publisher version
AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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