EP708 Multidisciplinary approach to management of fistulae in gynaecological oncology – 5 year experience. (1st November 2019)

• Record Type: Journal Article
• Authors: Farrag, A; Chandrasekaran, D; Powell, M; Brockbank, E; Lawrence, A; Jeyarajah, A; Miller, R; Phadnis, S
• Is Part Of: International journal of gynecological cancer. Volume 29(2019)Supplement 4
• Page Start: A402
• Page End: A402
• Publication Date: 2019-11-01
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2019-ESGO.762
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: Fistulas are uncommon complications in gynaecological malignancies; commonest occurring fistulas are vesicovaginal and enterocutaneous fistula. They may develop after primary malignancy, surgery, recurrence or radiation therapy. We report an observational cohort study. Methodology: Prospective identification and data collection on all cases with fistula related to gynaecological malignancy was undertaken between 2014 and 2018. Patient demographics, co-morbidities, cancer type & stage, investigations, management and outcomes were collated and analysed using descriptive statistics. Results: A total of 17 patients were identified (1% total n=1485), out of which 12 developed a fistula post operatively, 4 after chemo radiotherapy, and 1 case post recurrence. Among the 17 patients, 5 patients developed Enterocutaneous fistula, 3 uretro-vaginal fistula, 3 vesico-vaginal fistula, 3 rectovaginal fistula and 3 colovaginal fistula. CT scan was the main diagnostic tool in all these case. There were no correlations between developing a fistula and age, BMI, previous abdominal surgery, type or stage of cancer and type of procedure. All fistulas were managed with multidisciplinary approach from the outset, including medical & clinical oncology, nutrition, interventional radiology, colorectal & urological surgeons, tissue viability, and extensive clinical nurse specialist support. Vesico-vaginal fistulas and post-radiotherapy rectovaginal and colovaginal fistulas were managed surgically. All others were managed conservatively with full resolution. Conclusion: Fistulas in gynaecological oncology are an uncommon complication. CT scan is the preferred imaging modality for diagnosis. Early multi-disciplinary approach is pivotal to successful management. Disclosure: AF, DC, MP, EB, AL, ARJ, RM, SP declare no conflict of interest.