Non-healing post-surgical fistulae: treatment with image-guided percutaneous injection of cyanoacrylic glue

Giovanni Mauri, Lorenzo C Pescatori, Chiara Mattiuz, Dario Poretti, Vittorio Pedicini, Fabio Melchiorre, Umberto Rossi, Luigi Solbiati, Luca Maria Sconfienza

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVES: To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments.

METHODS: Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection.

RESULTS: In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient.

CONCLUSIONS: Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.

Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalRadiologia Medica
Volume122
Issue number2
DOIs
Publication statusPublished - Feb 2017

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Adhesives
Fistula
Injections
Therapeutics
Treatment Failure
Reoperation
Tomography
Ethiodized Oil
Italy
Drainage

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Cyanoacrylates/administration & dosage
  • Digestive System Surgical Procedures/adverse effects
  • Feasibility Studies
  • Female
  • Humans
  • Injections, Intralesional
  • Intestinal Fistula/etiology
  • Male
  • Middle Aged
  • Postoperative Complications/therapy
  • Radiography, Interventional/methods
  • Retrospective Studies
  • Tissue Adhesives/administration & dosage
  • Tomography, X-Ray Computed/methods
  • Treatment Outcome
  • Wound Healing

Cite this

Non-healing post-surgical fistulae : treatment with image-guided percutaneous injection of cyanoacrylic glue. / Mauri, Giovanni; Pescatori, Lorenzo C; Mattiuz, Chiara; Poretti, Dario; Pedicini, Vittorio; Melchiorre, Fabio; Rossi, Umberto; Solbiati, Luigi; Sconfienza, Luca Maria.

In: Radiologia Medica, Vol. 122, No. 2, 02.2017, p. 88-94.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVES: To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments.METHODS: Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection.RESULTS: In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 {\%}) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient.CONCLUSIONS: Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.",
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author = "Giovanni Mauri and Pescatori, {Lorenzo C} and Chiara Mattiuz and Dario Poretti and Vittorio Pedicini and Fabio Melchiorre and Umberto Rossi and Luigi Solbiati and Sconfienza, {Luca Maria}",
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T1 - Non-healing post-surgical fistulae

T2 - treatment with image-guided percutaneous injection of cyanoacrylic glue

AU - Mauri, Giovanni

AU - Pescatori, Lorenzo C

AU - Mattiuz, Chiara

AU - Poretti, Dario

AU - Pedicini, Vittorio

AU - Melchiorre, Fabio

AU - Rossi, Umberto

AU - Solbiati, Luigi

AU - Sconfienza, Luca Maria

PY - 2017/2

Y1 - 2017/2

N2 - OBJECTIVES: To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments.METHODS: Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection.RESULTS: In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient.CONCLUSIONS: Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.

AB - OBJECTIVES: To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments.METHODS: Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection.RESULTS: In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient.CONCLUSIONS: Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.

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KW - Humans

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KW - Middle Aged

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KW - Radiography, Interventional/methods

KW - Retrospective Studies

KW - Tissue Adhesives/administration & dosage

KW - Tomography, X-Ray Computed/methods

KW - Treatment Outcome

KW - Wound Healing

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DO - 10.1007/s11547-016-0693-7

M3 - Article

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VL - 122

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EP - 94

JO - Radiologia Medica

JF - Radiologia Medica

SN - 0033-8362

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ER -