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Medicina Clinica Dec 2023
Topics: Humans; Cutaneous Fistula
PubMed: 37532618
DOI: 10.1016/j.medcli.2023.05.022 -
The New England Journal of Medicine Feb 2023
Topics: Humans; Cutaneous Fistula; Dental Fistula
PubMed: 36780678
DOI: 10.1056/NEJMicm2209259 -
Dermatologic Surgery : Official... Oct 2022
Topics: Cutaneous Fistula; Humans
PubMed: 36191133
DOI: 10.1097/DSS.0000000000003568 -
The Laryngoscope May 2014Concurrent chemoradiotherapy is the gold-standard nonsurgical organ-preservation treatment for advanced laryngeal carcinoma. Total laryngectomy (TL) is increasingly... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES/HYPOTHESIS
Concurrent chemoradiotherapy is the gold-standard nonsurgical organ-preservation treatment for advanced laryngeal carcinoma. Total laryngectomy (TL) is increasingly reserved for surgical salvage. Salvage surgery is associated with more complications than primary surgery. A systematic review and meta-analysis was undertaken to establish the impact of organ preservation protocols on pharyngo-cutaneous fistula incidence following TL, and to synthesize evidence on the role of "onlay" prophylactic tissue flaps in reducing this complication in salvage TL.
DATA SOURCES
The English language literature (January 1, 2000, to September 1, 2013) was searched, using PUBMED and EMBASE databases, for the terms "laryngectomy" and "fistula." Of 522 studies identified from database searches, 33 were included in the quantitative synthesis.
REVIEW METHODS
Studies reporting fistula incidence following primary TL (PTL), salvage TL (STL), and STL with "onlay" flap-reinforced pharyngeal closure were included. Data were extracted by the first author (M.S.). Meta-analysis of fistula incidence was performed.
RESULTS
PTL fistula incidence is 14.3% (95% CI 11.7-17.0), STL 27.6% (23.4-31.8), and STL with flap-reinforced closure 10.3% (4.6-15.9). Chemoradiotherapy is associated with a pooled fistula incidence of 34.1% (22.6-45.6), compared to 22.8% (18.3-27.4) for radiotherapy alone. Relative risk of fistula is 0.566 (0.374-0.856, P = 0.001) for STL with flap-reinforced closure compared to STL alone. The number needed to treat (NNT) to prevent one fistula is 6.05.
CONCLUSION
Prophylactic flaps used in an "onlay" technique reduce fistula incidence in STL. Chemoradiotherapy increases fistula incidence more than radiotherapy alone. Prophylactic flaps should be offered in salvage cases after failed chemoradiation protocols.
Topics: Combined Modality Therapy; Cutaneous Fistula; Fistula; Humans; Laryngeal Neoplasms; Laryngectomy; Pharyngeal Diseases; Salvage Therapy; Surgical Flaps
PubMed: 24122657
DOI: 10.1002/lary.24448 -
BMJ Case Reports Feb 2024A multiparous woman in her 20s, presented to the clinic with bleeding from caesarean scar site. After clinical examination and radiological evaluation with ultrasound...
A multiparous woman in her 20s, presented to the clinic with bleeding from caesarean scar site. After clinical examination and radiological evaluation with ultrasound and MR fistulogram, the diagnosis was utero-cutaneous fistula. Complete resection of fistulous tract with uterine defect closure and supportive omental patch placement was done after an intraoperative demonstration of the utero-cutaneous fistula by injecting methylene blue dye. Utero-cutaneous fistula is a rare complication after caesarean section. Cyclical bleeding from an abnormal opening in previous caesarean scar site is the classical presentation of this condition.
Topics: Female; Humans; Pregnancy; Cesarean Section; Cicatrix; Cutaneous Fistula; Ultrasonography; Uterus; Adult
PubMed: 38331447
DOI: 10.1136/bcr-2023-255901 -
Annales de Dermatologie Et de... Dec 2015Spontaneous cutaneous fistula of hydatid liver cysts is a rare complication. Its genesis involves anatomic factors as well as other local factors. (Review)
Review
BACKGROUND
Spontaneous cutaneous fistula of hydatid liver cysts is a rare complication. Its genesis involves anatomic factors as well as other local factors.
AIMS
An exhaustive literature review was conducted to identify the characteristics of this complication, treatment modalities and the results obtained.
PATIENTS AND METHODS
An exhaustive bibliographic search was made for all articles published in French and English relating to parietal complications of hydatid liver cyst, from which we retained only those involving cases of cutaneous cyst fistulas (communicating rupture), to which we added our own case.
RESULTS
Seventeen cases of cystocutaneous fistula have been reported. The reason for consultation was productive cutaneous fistula. Morphological investigations were highly evocative of the diagnosis. Thirteen patients were treated by surgery, two underwent percutaneous debridement, and two declined treatment.
DISCUSSION
Cutaneous fistula constitutes a rare mode of discovery of hydatid cyst. Fistulography and CT scan are extremely useful for diagnosis. Percutaneous debridement of the hydatid cyst represents a debatable alternative to surgical therapy.
Topics: Cutaneous Fistula; Digestive System Fistula; Echinococcosis, Hepatic; Humans; Liver Diseases
PubMed: 26563822
DOI: 10.1016/j.annder.2015.10.580 -
CMAJ : Canadian Medical Association... Nov 2019
Topics: Cheek; Cutaneous Fistula; Diagnosis, Differential; Female; Humans; Middle Aged; Tooth Diseases
PubMed: 31740538
DOI: 10.1503/cmaj.190674 -
Journal of Postgraduate Medicine 2013A 37-year-old woman with a vesico-cutaneous hip fistula was admitted to our department. The bladder fistula had formed after repeated hip infections. The fistula was... (Review)
Review
A 37-year-old woman with a vesico-cutaneous hip fistula was admitted to our department. The bladder fistula had formed after repeated hip infections. The fistula was completely resected and the bladder was repaired using a tension-free closure and indwelling catheter for 2 weeks. Vesico-cutaneous fistulae are very rare, and their causes can be complex.
Topics: Abscess; Adult; Chronic Disease; Cutaneous Fistula; Female; Hip; Humans; Muscular Diseases; Radiography; Urinary Bladder Fistula
PubMed: 24029202
DOI: 10.4103/0022-3859.118043 -
World Neurosurgery Oct 2020Tension pneumoventricle (TPV) is a subtype of tension pneumocephalus in which the air is trapped inside the ventricles through a one-way osteodural defect, causing an... (Review)
Review
BACKGROUND
Tension pneumoventricle (TPV) is a subtype of tension pneumocephalus in which the air is trapped inside the ventricles through a one-way osteodural defect, causing an increase in intracranial pressure. TPV secondary to cutaneous-ventricular fistula has been reported only twice in the literature.
CASE DESCRIPTION
Herein, we report the third case in a 53-year-old woman who developed TPV with decreased level of consciousness after removal of a posterior fossa meningioma while she was on external ventricular drainage. There was no identifiable bony defect on neuroimaging. The drain was changed urgently, and the fistula located at the drain tunneling site was sealed.
CONCLUSIONS
This case report highlights the importance of suspecting and treating cutaneous-ventricular fistulas in TPV urgently in patients without skull base defects or those who showed no improvements with external ventricular drainage.
Topics: Cerebral Ventricles; Cutaneous Fistula; Female; Humans; Middle Aged; Pneumocephalus; Postoperative Complications
PubMed: 32599189
DOI: 10.1016/j.wneu.2020.06.145 -
Journal of Pediatric Urology Aug 2021Clean intermittent catheterization (CIC) is fundamental in managing children with impaired bladder function. However, it is not always feasible via the native urethra...
BACKGROUND
Clean intermittent catheterization (CIC) is fundamental in managing children with impaired bladder function. However, it is not always feasible via the native urethra predominately males with intact sensation.
AIM
In the current study, the experience regarding a modified vesico-cutaneous fistula (VCF) technique for CIC in children is reported.
PATIENTS AND METHODS
From January 2018 to January 2020, the modified VCF was performed to cases with impaired bladder function for CIC. Before surgery, patients were evaluated thoroughly. The anteroposterior diameter (APD) of the renal pelvis was considered as an indicator of the degree of affection of the upper urinary tract. Postoperative attacks of UTIs, leakage from the fistula, fistula stenosis, and the need for revision were recorded. The technique was accomplished relying on the principles of open Stamm gastrostomy (Fig. 1).
RESULTS
Eight cases underwent a modified VCF due to different pathologies. Their ages, at time of the surgery, ranged from 1 month to 14/ years. The median postoperative follow up period was 12 months. A leakage between catheterizations was experienced in 1 case. Stenosis of the fistula occurred in 1 case and it required surgical revision. No symptoms or signs of urinary tract infection were encountered. The mean APD of the renal pelvis was reduced from 29.8 mm (SD: ±14.6 mm), in the preoperative evaluation, to 17.6 mm (SD: ±10.85 mm) in the postoperative follow up.
DISCUSSION
Vesico-cutaneous fistula is a new technique that provides easy and direct way for CIC. In the current study, a modified VCF technique was introduced to the enrolled patients as a simple maneuver, to make easy self-catheterization. Despite the limitations of this study due to the lack of a control group, the small number of cases, and the short follow up period, this modified technique was able to create a short and straightforward channel to access the bladder for intermittent catheterization. It could be done in redo cases. Results showed an acceptable degree of continence and low rate of complications. Moreover, it was socially accepted among our patients.
CONCLUSION
Intermittent catheterization in children, with abnormal bladder function, can be done easily and efficiently via a modified VCF.
Topics: Child; Cutaneous Fistula; Humans; Infant; Intermittent Urethral Catheterization; Male; Urinary Bladder Fistula; Urinary Bladder, Neurogenic; Urinary Catheterization
PubMed: 33985914
DOI: 10.1016/j.jpurol.2021.04.013