Risk Factors for a Persistent Gastrocutaneous Fistula Following Gastrostomy Device Removal: A Tertiary Center...

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Gastrocutaneous fistulas (GCF) can persist after gastrostomy device (GD) removal.
• Identifying risk factors for persistent GCF is crucial for managing pediatric patients.

Purpose of the Study:

• To identify risk factors associated with persistent GCF following GD removal in children.
• To inform patient counseling and management strategies.

Main Methods:

• Retrospective analysis of 59 pediatric patients undergoing GD insertion and removal (2005-2015).
• Patients categorized into persistent GCF (Group A) or spontaneous closure (Group B).
• Analysis of demographics, comorbidities, device details, and procedural factors using Chi-square and ANOVA tests.

Main Results:

• 34 patients developed persistent GCF post-GD removal.
• Younger age at insertion (<2 years), longer device placement duration, open insertion technique, device upsizing, tube-to-button changes, and site infections were significant risk factors.
• Underlying comorbidities did not impact spontaneous closure.

Conclusions:

• Persistent GCF after GD removal is influenced by several identifiable risk factors.
• Potentially reversible factors like site infections and insertion methods were identified.
• Risk analysis is vital for pre-procedural patient counseling and optimizing GD management.