Surgical strategy for complex perineal small bowel fistula after pelvic malignancy: An etiology-driven approach

doi:10.4240/wjgs.120918

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 120918
Published online Aug 27, 2026. doi: 10.4240/wjgs.120918

Table 3 Odds ratio analysis for the selection of internal intestinal plication

Variable: Predictor	Reconstruction (n = 15)	Plication (n = 13)	OR	95%CI	P value
Tumor recurrence	4	8	4.00	0.77-20.8	0.09
Radiation enteritis	5	4	0.75	0.13-4.23	0.74
Empty pelvis syndrome	3	0	0.00	0.00-NA	0.23
Surgical injury	2	1	0.43	0.03-5.56	0.52

Multivariate evaluation assessing the likelihood of a specific pathology dictating the use of internal intestinal plication. Tumor recurrence represents the strongest clinical predictor for selecting plication, reflecting the surgical necessity to manage diffuse, malignant adhesive disease rather than attempting to fill a non-existent pelvic void. Patients with tumor recurrence had 4-fold higher odds of undergoing internal intestinal plication (group 2) compared to reconstruction, reflecting the preference for plication in frozen, malignant pelvises. OR: Odds ratio; CI: Confidence interval; NA: Not applicable.

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Citation: Wu TQ, Yang JF, He L, Gao RY, Wang SL, Pang BR, Wang FT, Yin L, Chen CQ, Wu XC. Surgical strategy for complex perineal small bowel fistula after pelvic malignancy: An etiology-driven approach. World J Gastrointest Surg 2026; 18(8): 120918
URL: https://www.wjgnet.com/1948-9366/full/v18/i8/120918.htm
DOI: https://dx.doi.org/10.4240/wjgs.120918

Wu TQ, Yang JF, He L, Gao RY, Wang SL, Pang BR, Wang FT, Yin L, Chen CQ, Wu XC. Surgical strategy for complex perineal small bowel fistula after pelvic malignancy: An etiology-driven approach. World J Gastrointest Surg 2026; 18(8): 120918 [DOI: 10.4240/wjgs.120918]

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