Analysis of factors affecting the spontaneous closure of a gastrocutaneous fistula.
OBJECTIVE
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.
Department of Pediatric Surgery, The Children's Hospital/University of Colorado Health Sciences Center, Denver, CO, USA.
Tracey A
TA
Janik
Richard J
RJ
Hendrickson
Joseph S
JS
Janik
Angi E
AE
Landholm
D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000209:etiology / Q000503:physiopathology; D020878:Device Removal; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005747:Gastric Fistula / Q000209:etiology / Q000503:physiopathology; D005774:Gastrostomy / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014945:Wound Healing