Application and clinical value of nutritional support therapy in patients with enterocutaneous fistula

YANG Fan; WANG Xin-ying

doi:10.19538/j.cjps.issn1005-2208.2025.03.11

Abstract：Enterocutaneous fistula(ECF)is a critical emergency in gastrointestinal surgery,typically caused by surgical trauma,infection,inflammatory bowel disease,or malignancy.The progression of this condition is often associated with hypermetabolism,negative nitrogen balance,malnutrition,and electrolyte imbalances,severely affecting clinical outcomes and increasing mortality rates.Accurate nutritional support is essential to meet the patient's energy and nutritional needs,regulate the systemic metabolic state,promote tissue repair,and enhance immune function.The staged nutritional support treatment is crucial for patients'recovery and is divided into three major phases:the infection phase,the phase of living with the fistula,and the perioperative phase.Nutritional strategies for each stage focus on infection control,correction of electrolyte imbalances,and the gradual restoration of enteral and parenteral nutrition,respectively,with adequate protein and energy intake promoting fistula healing and disease stabilization.Early,appropriate nutritional support not only enhances the self-healing rate of ECF patients but also significantly reduces mortality.In particular,during the infection phase,a timely combination of enteral and parenteral nutrition effectively maintains the patient's nutritional status and prevents complications.Specific trace elements such as zinc,selenium,and immune-nutrients(e.g.,ω-3 fatty acids and glutamine)play an essential role in the recovery of ECF patients.With advancements in technology,emerging techniques like 3D-printed fistula stents and functionalized biological patches provide innovative solutions for clinical treatment,further optimizing personalized treatment strategies and potentially improving treatment outcomes and patient prognosis.