Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2017; 23(41): 7489-7494
Published online Nov 7, 2017. doi: 10.3748/wjg.v23.i41.7489
3D-printed “fistula stent” designed for management of enterocutaneous fistula: An advanced strategy
Jin-Jian Huang, Jian-An Ren, Ge-Fei Wang, Zong-An Li, Xiu-Wen Wu, Hua-Jian Ren, Song Liu
Jin-Jian Huang, Jian-An Ren, Ge-Fei Wang, Xiu-Wen Wu, Hua-Jian Ren, Department of Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
Jin-Jian Huang, School of Medicine, Southeast University, Nanjing 210009, Jiangsu Province, China
Zong-An Li, NARI School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing 210042, Jiangsu Province, China
Song Liu, Department of General Surgery, Nanjing Drum Tower Hospital, Nanjing 210008, Jiangsu Province, China
Author contributions: Huang JJ and Ren JA designed this report; Wang GF performed the 3D-reconstructed fistulography; Huang JJ and Li ZA fabricated this 3D-printed fistula stent; Ren JA and Ren HJ implanted the fistula stent; Wu XW and Liu S followed up the patient and recorded his medical information.
Supported by the National Natural Science Foundation of China, No. 81571881.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: We declared no potential conflicts of interest with respect to the research, authorship and publication of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jian-An Ren, MD, FACS, Director, Department of Surgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China. jiananr@gmail.com
Telephone: +86-13605169808 Fax: +86-25-80860376
Received: September 19, 2017
Peer-review started: September 20, 2017
First decision: September 27, 2017
Revised: September 29, 2017
Accepted: October 18, 2017
Article in press: October 17, 2017
Published online: November 7, 2017
Abstract

Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as “fistula patch” and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage. However, failures are encountered due to high-output fistula and anatomical complexity. Here, we report 3D-printed patient-personalized fistula stent for ECF treatment based on 3D reconstruction of the fistula image. Subsequent follow-up demonstrated that this stent was well-implanted and effective to reduce the volume of enteric fistula effluent.

Keywords: Enterocutaneous fistula, 3D printing, Open abdomen, Isolation technique

Core tip: There are few reports about how to manage enterocutaneous fistulas (ECFs) after open abdomen, especially those that are unlikely to achieve spontaneous closure. This case report describes how to use 3D printing technique to fabricate a fistula stent in accordance with the ECF anatomy, and how the stent can improve enteric effluent, patient’s nutrition and physical strength, and surrounding wound inflammation.