Analysis of factors affecting the spontaneous closure of a gastrocutaneous fistula
Tracey A Janik1, Richard J Hendrickson, Joseph S Janik
1Department of Pediatric Surgery, The Children's Hospital/University of Colorado Health Sciences Center, Denver, CO, USA.
Insights
A persistent gastrocutaneous fistula (GCF) after gastrostomy removal occurred in 34% of pediatric patients. The only factor correlating with GCF persistence was the time elapsed before gastrostomy removal.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Outcomes
Background:
- Gastrocutaneous fistulas (GCFs) can persist after gastrostomy tube removal.
- Limited data exists on GCF persistence rates and associated factors in pediatric populations.
Purpose of the Study:
- To determine the incidence of persistent GCF in pediatric patients post-gastrostomy removal.
- To identify clinical factors correlating with GCF persistence.
Main Methods:
- Retrospective review of 1,042 pediatric patients who underwent gastrostomy creation between 1992 and 2002.
- Analysis of clinical parameters in patients with persistent GCF after gastrostomy removal.
Main Results:
- A persistent GCF was observed in 150 children, yielding an incidence of 34%.
- Time to gastrostomy appliance removal (≤8 months vs. >8 months) was the sole significant factor correlating with GCF persistence (P <.05).
- No other clinical parameters showed a conclusive correlation with GCF persistence.
Conclusions:
- The duration of the gastrostomy appliance in situ is the primary determinant of persistent GCF after removal.
- Surgically created GCFs are influenced by time to removal.
Background/Purpose:
Few reports have documented the rate of persistence of a gastrocutaneous fistula (GCF) after gastrostomy removal or the reason for the persistence of a GCF. The purpose of this report was to analyze a large group of pediatric patients with a persistent GCF to determine the rate of persistence and any factors that correlate with the persistence of a GCF.
Methods:
This was a retrospective review of 1,042 children from The Children's Hospital, Denver, Colorado who had a gastrostomy constructed between 1992 and 2002. The charts of all children with a persistent GCF after gastrostomy catheter removal were analyzed for correlation between 13 clinical parameters and the persistence of a GCF.
Results:
There were 150 children with a persistent GCF for an incidence of 34%. Time elapsed between the creation of the GCF and removal of the gastrostomy appliance (< or =8 months versus >8 months) was the only parameter that showed any correlation with persistence of a GCF (P <.05). None of the other parameters studied showed any conclusive correlation with persistence of a GCF.
Conclusions:
Time was the only factor that determined whether a surgically created GCF would persist after removal of a gastrostomy appliance.
