Table of Contents
ISRN Gastroenterology
Volume 2011 (2011), Article ID 686803, 3 pages
http://dx.doi.org/10.5402/2011/686803
Clinical Study

Incidence and Predictors of Gastrocutaneous Fistula in the Pediatric Patient

Pediatric General Surgery, Department of Surgery, Stollery Children's Hospital, University of Alberta, 2C3.56 WMC, 8440-112 Street, Edmonton, Alberta, Canada T6G 2B7

Received 25 September 2010; Accepted 28 October 2010

Academic Editors: D. Beattie and V. Velanovich

Copyright © 2011 Ioana Bratu and Aamir Bharmal. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 . 5 7 (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.