{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:16:30Z","timestamp":1767849390718,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the feasibility, safety, and efficacy of massive continuous irrigation (MCI) and endoscopic debridement for the treatment of refractory abscess\u2013fistula complexes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective single\u2010center observational study involving 12 patients with refractory abscess\u2013fistula complexes. All patients had experienced long\u2010term treatment failure or had failed multiple treatment modalities. We used over two catheters and inserted them via the gastrointestinal (GI) tract or percutaneously to form a circulation pathway to achieve MCI of normal saline, endoscopic debridement was then performed. The treatment success rate, irrigation volume and treatment duration, time to abscess\u2013fistula complex closure, intra\u2010treatment complications, and recurrence rate were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The treatment success rates were 100%. The median time of previous treatment was 32\u2009days (range 7\u2013912\u2009days). The mean time from the use of the novel treatment strategy to abscess\u2013fistula complex healing was 18.8\u2009\u00b1\u200911.0\u2009days. The mean volume of irrigation was 10\u2009804\u2009\u00b1\u20091669\u2009mL\/24\u2009h. The mean irrigation time was 16.5\u2009\u00b1\u20099.2\u2009days, and a median of two irrigation tubes (range 2\u20135) were used. No complications occurred either during or after the procedure. During the follow\u2010up of 23.1\u2009\u00b1\u200918.1\u2009months, no recurrence or adverse events were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MCI and endoscopic debridement may be a feasible, safe, and effective alternative treatment for refractory abscess\u2013fistula complexes. Large prospective studies are needed to validate our results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.13257","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T09:34:23Z","timestamp":1711013663000},"page":"133-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Massive continuous irrigation (<scp>MCI<\/scp>) and endoscopic debridement as an alternative treatment strategy for refractory abscess\u2010fistula complexes"],"prefix":"10.1111","volume":"25","author":[{"given":"Yue","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saif","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing Fen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-4343","authenticated-orcid":false,"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li Xia","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De Liang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6101-8675","authenticated-orcid":false,"given":"Bing Rong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-008-0716-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-016-0649-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.184.1.1376932"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.143.4.811"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(92)72044-2"},{"issue":"6","key":"e_1_2_8_7_1","first-page":"385","article-title":"Proposed definitions for the audit of postoperative infection: a discussion paper","volume":"73","author":"Peel AL","year":"1991","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01829.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1986.01400020049005"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/22.Supplement_A.87"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-004-0281-4"},{"issue":"4","key":"e_1_2_8_13_1","first-page":"517","article-title":"Determinants of death in patients with intraabdominal abscess","volume":"88","author":"Fry DE","year":"1980","journal-title":"Surgery"},{"issue":"5","key":"e_1_2_8_14_1","first-page":"913","article-title":"Abdominal abscess. 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