Incidence and Predictors of Gastrocutaneous Fistula in the Pediatric Patient

Abstract EN

Background/Purpose.

To determine the incidence, predictors, and outcomes of repair of gastrocutaneous fistulae (GCF) in pediatric patients.

Methods.

Patients were identified through a medical records search of all gastrostomy insertions performed from 1997–2007.

Results.

Of 1083 gastrostomies, 49 had GCF closure.

Gastrostomy indications were reflux/aspiration (30/43 [70%]) and feeding intolerance/failure to thrive (7/43 [16%]).

Gastrostomies were performed as open surgical procedures (84%) with fundoplication (66% of all cases) at an age of 0.5±0.57 (median ± inter-quartile range) years.

Gastrostomies were removed in outpatient settings when no longer used and were present for 2.3±2.2 years, and GCF persisted for 2.0±3.0 months.

GCF were closed by laparotomy and stapling.

GCF closure length of stay was 2.0±3.3 days.

Complications occurred in 6/49 patients and included infection/fever (4/6) and localized skin redness/breakdown (2/6).

Conclusions.

From our collected data, GCFs occur at a frequency of 4.5% and persist for 2.0±3.0 months until closed.

Given the complicated medical histories of patients and relatively high rate of postoperative infection/reaction (12.2%), GCF closure is not a benign, “uncomplicated” procedure.

Further information describing factors determining which patients develop GCF requiring closure is needed.