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The PEET procedure: Punch Excision of Epithelialized Tracts for gastrocutaneous fistula closure

Cody Lendon Mullens1, Joanna Twist1, Patrick C Bonasso2

  • 1West Virginia University School of Medicine, Morgantown, WV, USA.

Journal of Pediatric Surgery
|July 6, 2021
PubMed

Insights

Punch Excision of Epithelialized Tracts (PEET) offers a novel, effective method for treating persistent pediatric gastrocutaneous fistulas (GCF). This minimally invasive technique shows promise for efficient GCF management with no observed complications in a small patient group.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Persistent gastrocutaneous fistula (GCF) is a frequent challenge in pediatric patients.
  • Current management options for pediatric GCF include open surgery and medical treatments.
  • A novel technique, Punch Excision of Epithelialized Tracts (PEET), is introduced for GCF excision.

Purpose of the Study:

  • To describe a novel adaptation of a punch biopsy technique for excising pediatric GCF.
  • To evaluate the short-term efficacy and safety of the PEET approach.
  • To assess the potential for resource utilization and time efficiency of the PEET procedure.

Main Methods:

  • The PEET technique involves using a punch biopsy tool passed over a Foley catheter.
  • The catheter is inserted into the GCF tract, balloon inflated, and retracted.
  • The punch biopsy instrument excises the tract circumferentially.

Main Results:

  • Four pediatric patients with persistent GCF underwent the PEET procedure.
  • The mean duration of GCF prior to intervention was 9 months.
  • No post-operative complications were reported in the cohort during a mean follow-up of 7.8 months.

Conclusions:

  • The PEET approach demonstrates short-term efficacy in managing pediatric GCF.
  • This technique may offer advantages in terms of hospital resource utilization and procedure time.
  • Further investigation in larger cohorts is warranted to confirm these preliminary findings.
Abstract

Keywords:
Feeding tubeG tubeGastrocutaneous fistulaPediatric gastrocutaneous fistulaPersistent gastrocutaneous fistula

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