External enterocutaneous fistula is a postoperative complication of abdominal surgery and is still a very difficult problem for surgeons. If the treatment is not timely and standardized, fatal complications such as severe sepsis, hemorrhage from the fistula, severe water-electrolyte imbalance, and severe malnutrition will follow. On the contrary, if the diagnosis and treatment are timely and standardized, the above-mentioned serious complications can be nipped in the bud and cradled in time, so that patients can recover as soon as possible. I have worked in Nanjing General Hospital of Nanjing Military Region for nearly 3 years as a postdoctoral fellow (extra-intestinal fistula and abdominal cavity infection), and after my release, I joined Aviation General Hospital of China Medical University, where I have been working on the treatment of extra-intestinal fistula and abdominal cavity infection. In the process of fighting with this disease, which most surgeons are afraid of, I have been helpless, disappointed, and confused, but more often than not, after active treatment, through standardized treatment, after unremitting efforts to get the patient’s recovery, seeing the smiling faces of patients and their families, at that moment my heart is sincerely gratified. I am very happy to see the smiling faces of patients and their families. The following are some of my experiences in the diagnosis and treatment of parenteral fistula. The best thing to do is to find the main contradiction of the matter, so that the matter will be solved with half the effort. This is also true for the management of parenteral fistula. I think the key point to solve the fistula is “fistula”, to control, reduce, and even temporarily close the fistula, we need to find ways to drain the intestinal contents that leak into the abdominal cavity, otherwise the intestinal contents that can be quiet in the gastrointestinal tract will leak into the abdominal cavity and cause serious infection, erosion of surrounding tissues and blood vessels Hemorrhage occurs at the place of intestinal fistula. Due to the large loss of intestinal contents, it also causes serious water and electrolyte disorders in the body. For colonic fistulas and fistulas of the distal intestine, an enterostomy at the proximal end of the fistula can be performed in time to achieve the purpose of diversion of intestinal contents. This temporary intestinal stoma method I think many physicians will accomplish. However, patients with complex fistulas, multiple fistulas, and extraintestinal fistulas that cannot be diverted through an enterostomy require effective and adequate drainage, i.e., control of the source of infection. I often see patients with enterocutaneous fistulas transferred from outside hospitals with thick dressings on their abdominal enterocutaneous fistulas, and when the dressings are opened, a pungent smell comes over them, and the tissues and surrounding skin of the enterocutaneous fistula are ulcerated and red. This is a way to cover up the thick dressing, although the dressing is not visible for a while, the visual sensory is better, but in fact, the intestinal fluid, intestinal content is still under the dressing source, continue to wreak havoc. The key to treatment at this time is drainage, which requires a different kind of drainage than the latex drainage tubes routinely placed after abdominal surgery, which we call active drainage and can be accomplished by a special drainage tube called “Lai’s double cannula”. Of course, the application of the double cannula is also very delicate in terms of replacement techniques, placement, depth, diameter, flushing volume control, negative pressure setting, drainage fluid detection, etc. For enterocutaneous fistulas that cannot be controlled by double cannula drainage, it is important to actively identify the source of infection in other parts of the abdominal cavity, which can be accomplished by surgical drainage, CT-guided tube drainage or transabdominal Troca puncture drainage, etc. In conclusion, timely, rapid, and effective control of the contents of the intestine into the abdominal cavity will greatly reduce the occurrence of all complications of enterocutaneous fistula, which is like decisively dousing a fire with a basin of water right after it has just started. If the fire is not treated in time, it will be very difficult to end it when the fire is already high and the fire extends. Another lesson learned is the importance of enteral nutrition support in the treatment of enterocutaneous fistulas. Clinical nutritional support is a relatively new technology, and due to the development of nutritional support technology, many critically ill patients, patients with gastrointestinal dysfunction, and patients with abdominal infections and parenteral fistulas have been effectively cured. In my personal opinion, enteral nutrition is more effective, attractive and artistic than parenteral nutritional support in the treatment of enterocutaneous fistula. However, many patients with enterocutaneous fistula sometimes have some resistance to enteral nutrition support, complaining that the nasal feeding tube is uncomfortable and wanting very much to be able to take big mouthfuls of soup and food. Little do they know that it is the foundation of enteral nutrition at this stage that ensures that enterocutaneous fistula patients can eat properly later in life. The importance of enteral nutrition has been outlined by a leading American surgeon: once a critically ill patient is restored to enteral nutrition, the treatment of that critically ill patient is halfway done. In addition, enteral nutrition has more advantages than parenteral nutrition support: it is more consistent with the physiological processes of the body; it reduces many of the complications associated with parenteral nutrition, such as hepatic insufficiency, biliary sludge, and catheter-associated infections; it maintains the intestinal mucosal barrier and reduces the occurrence of bacterial ectopic flora; it protects liver function; it promotes the formation of benign adhesions between intestinal collaterals; it reduces the occurrence of intestinal obstruction; and enteral nutrition support is an important part of the treatment of intestinal fistula. The restoration of enteral nutrition will be of great benefit to the patient. Therefore, we hope that patients with enterocutaneous fistula can see the benefits of enteral nutrition and actively cooperate with enteral nutrition support, because ultimately, it is the patient with enterocutaneous fistula who benefits. There are many other important techniques involved in the treatment of enterocutaneous fistulas, such as water and electrolyte regulation, homeostasis, collection and return of intestinal fluids, VAC therapy, open abdominal management, accurate assessment of enterocutaneous fistulas, management of sinus bleeding from enterocutaneous fistulas, NRS2002 assessment, support of vital organ function, definitive surgical treatment, etc. Here I only talk about my personal experience with “drainage” and “enteral nutrition support”, hoping that patients with enterocutaneous fistula will learn more about this disease and cooperate actively in its treatment. The risk of intestinal fistula is high, the treatment is difficult, the complications are many and dangerous, the course of the disease is long and costly, but we should also see that with timely, effective and standardized treatment, a significant number of patients with intestinal fistula can be cured. The treatment of intestinal fistula should be timely, standardized, careful and persistent. May more intestinal fistula patients can be treated effectively and recover soon.