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Abstract：
Introduction Enteroatmospheric fistulas (EAF) present significant challenges in surgical management due to their complex nature and high mortality rate. Traditional approaches often rely on prolonged parenteral nutrition, but emerging evidence suggests the potential benefits of enteral nutrition via fistuloclysis, an underappreciated enteral nutrition route. This study aims to evaluate the effectiveness of nutritional therapy, specifically fistuloclysis, in patients with EAF managed at the Trauma Unit of Santo Tomás Hospital, Panama. Methods A retrospective analysis was conducted on nine male patients diagnosed with EAF between January 2016 and December 2020. Data on demographics, fistula characteristics, and nutritional management were collected through chart review. Descriptive statistics were used for analysis. Results We analyzed nine patients, all of whom received enteral nutrition (EN) via fistuloclysis in a median of 5.5 days from the diagnosis of EAF. Seven patients required parenteral nutrition (PN) at the beginning. The use of specialized enteral formulas, supplemented with hydrolyzed proteins and medium-chain triglycerides, facilitated discontinuation of PN once 80% of nutritional requirements were met via the enteral route, and EN was continued until definitive surgery. The median duration of PN was 34 days. No adverse effects related to EN were observed, whereas complications such as central venous catheter infections were reported in all cases requiring PN. Conclusion Fistuloclysis is a viable and effective alternative to traditional PN in patients with EAF. Specialized nutritional strategies, including the use of semi-elemental formulas, contribute to improved outcomes and reduced complications. Early initiation and gradual increase in enteral nutrition via fistuloclysis demonstrate safety and efficacy, underscoring the importance of tailored nutritional approaches in optimizing patient care for complex surgical conditions.
摘要：
背景技术肠大气瘘(EAF)由于其复杂的性质和高的死亡率,在手术管理中提出了重大的挑战。传统的方法通常依赖于长期的肠外营养，但新出现的证据表明，肠内营养的潜在益处，被低估的肠内营养途径。这项研究旨在评估营养治疗的有效性，特别是溶栓，在圣托马斯医院创伤科治疗的EAF患者中，巴拿马。方法回顾性分析2016年1月至2020年12月收治的9例男性EAF患者的临床资料。人口统计数据，瘘管特征,和营养管理是通过图表审查收集的。描述性统计用于分析。结果我们分析了9例患者，所有这些人在诊断为EAF后的中位数为5.5天，通过纤维溶解术接受了肠内营养（EN）。七名患者在开始时需要肠外营养（PN）。使用专门的肠内配方，补充水解蛋白质和中链甘油三酯，一旦通过肠内途径满足80%的营养需求，就会促进PN的停药，并继续EN直到明确的手术。PN的中位持续时间为34天。未观察到与EN相关的不良反应，而在所有需要PN的病例中均报告了中心静脉导管感染等并发症。结论吸痰是EAF患者替代传统PN的有效方法。专门的营养策略，包括使用半元素公式，有助于改善预后和减少并发症。早期开始和逐步增加经肠内营养显示出安全性和有效性。强调量身定制的营养方法在优化复杂手术条件下患者护理方面的重要性。
