Nutritional Management and Strategies for the Enterocutaneous Fistula

Martin D. Rosenthal, Christian J. Brown, Tyler J. Loftus, Erin L. Vanzant, Chasen A. Croft, Robert G. Martindale

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Enterocutaneous Fistula (ECF) management remains a complex medical problem. Under best circumstances morbidity and mortality remains high. Best practice for nutrition management has remained stagnant since the development of parenteral nutrition by the late Stanley Dudrick in the 1960–1970s. This manuscript proposes that the old paradigm of exclusive parenteral nutrition for high output fistulas (> 500 cc/day) is antiquated and should be aborted based on contemporary evidence. Recent Findings: Through the development of modern management protocols for nutritional optimization, pre-habilitation of this patient population may become more efficient and impact morbidity and mortality in a positive manner. A review of the literature and inferences from other bodies of surgical management helps impact ECF care. Summary: Enhanced recovery after surgery will likely be the future for ECF patient, but outcomes of more randomized control trials studying ECF management must help guide the future.

Original languageEnglish (US)
Article number10
JournalCurrent Surgery Reports
Volume8
Issue number6
DOIs
StatePublished - Jun 1 2020

Keywords

  • ERAS
  • Enhanced recovery after surgery (ERAS)
  • Enterocutaneous fistula (ECF)
  • High output fistula
  • Immunonutrition
  • Nutrition protocol for fistulas
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Surgery

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