Successful closure of a recurrent enterocutaneous fistula using integrative traditional Chinese and Western medicine in ovarian cancer: A case report.

INTRODUCTION: Enterocutaneous fistula (ECF) is a severe postoperative complication with high morbidity and mortality, and spontaneous closure occurrings in only about approximately 50% of cases. Reports on recurrent ECF and the role of complementary therapies, such as traditional Chinese medicine (TCM), are limited. Herein, we aimed to report the case of a 61-year-old woman with recurrent high-grade serous ovarian carcinoma (HGSC), who developed an ECF following extensive abdominal surgery.

PATIENT PRESENTATION: A 61-year-old woman with recurrent high-grade serous ovarian carcinoma underwent four debulking surgeries, chemotherapy, radiotherapy, and hyperthermic intraperitoneal chemotherapy. After her fourth surgery which involved small bowel resection and anastomosis for peritoneal seeding, she developed an ECF in the right lower quadrant. Despite standard care, including prolonged fasting and total parenteral nutrition support, the fistula reoccurred thrice over nearly 1 year. In December 2023, the patient began integrative care with TCM decoctions aimed at reducing inflammation, enhancing circulation and nutrient absorption, and promoting tissue repair. After 4 months of integrative therapy, imaging confirmed fistula closure. Her cancer condition has remained stable, and she has resumed normal daily activities.

CONCLUSIONS: This case highlights that incorporating TCM in integrative care may enhance recovery and improve outcomes in refractory ECFs.