ReviewCureus2026
Microvascular Free Flap Transfer for the Closure of Recalcitrant Digestive Fistulas: A Systematic Review of Surgical Success, Definitive Closure, and Clinical Outcomes.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recalcitrant digestive fistulas are difficult to manage when local tissues are irradiated, infected, scarred, or depleted. Because pharyngocutaneous, enterocutaneous, esophageal, colorectal/perineal, and pancreatic fistulas are anatomically and biologically distinct, they were evaluated as site-stratified evidence rather than as a single pooled clinical entity. This review aimed to assess definitive fistula closure, flap survival, recurrence, complications, reoperation, mortality, and functional recovery after microvascular free flap transfer for established recalcitrant digestive fistulas. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-informed qualitative systematic review searched PubMed/MEDLINE, Embase, Scopus, Web of Science Core Collection, the Cochrane Library, Google Scholar, and reference lists. Heterogeneity in fistula anatomy, timing, flap selection, adjunctive procedures, and outcome definitions precluded a pooled meta-analysis. The review included 15 studies, including seven case series, six case reports, one retrospective cohort, and one technical clinical report, with sample sizes ranging from 1 to 50. Direct evidence was concentrated in post-laryngectomy pharyngocutaneous or pharyngostome fistulas. In studies with explicit extractable numerators, 25/25 flaps survived, but this figure derived from three small series and six case reports and excludes larger cohorts with incomplete or nonseparable reporting. Larger series reported substantial complications, revisions, and adjunctive procedures. Abdominal enterocutaneous evidence was limited to isolated salvage cases. Microvascular free flap transfer is a plausible salvage option for selected recalcitrant digestive fistulas, particularly in irradiated or surgically depleted head and neck fields. The evidence remains very low in certainty and does not support a single pooled closure estimate across fistula sites.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.