Post operative fistulas: enabling factors, clinic and management at Matanda Hospital from 2020 to 2022

Introduction: Postoperative digestive fistulas (PODF) complicate 0.5 to 4% of abdominal surgical procedures. These fistulas are often serious: they cause physical and psychological impact on the patient. They have economic consequences and cause significant mortality of 10 to 30%. We have set ourselves the general objective of studying the contributing factors, the diagnostic aspects and the management of PODF at Matanda hospital. Material and methods: We carried out a retrospective study which took the period from January 1, 2020 to December 31, 2022. We drew our data from the patients’ hospitalization files. Our sample consisted of patients who presented with a digestive fistula postoperatively. Results: Out of a population of 307 having undergone digestive tract surgery, 43 developed PODF following the operation, representing a frequency of 14.00%. Weight loss increased the risk of developing PODF by 5.53 times in the proportions of 81.9% in the sample and 47.6% in the population. Anemia increased the risk of developing PODF by 12.89 times in the proportions of 92.2% in our sample and 55.7% in the population. The fact that the small intestine was involved in the primary intervention increased the risk of developing PODF by 4.58 times in the proportions of 78.7% in the sample and 43.6% in the population. Most of the PODFs appeared between 5 and 10 days post-operatively, i.e. 41.9%. Fifty-five point eight percent of PODFs were found in the small intestine. Surgical management was the majority at 32.6%, consisting of resection followed by end-to-end anastomosis. A flow rate of less than 250 ml increased the chance of being cured of an PODF by 8.7 times. Conclusion: Postoperative external digestive fistulas are serious complications of digestive surgery.