title: Combined endoscopic cautery and clip closure of chronic gastrocutaneous fistulas.
abstract: BACKGROUND
  Chronic gastrocutaneous fistula with intermittent drainage is a common outcome after removing long-standing gastrostomy tubes. The standard treatment is surgery with laparotomy and excision of the fistula tract. This study describes the results of an endoscopic closure technique by using a combination of electrocautery and metal clips.
  
  
  METHODS
  Three patients with gastrocutaneous fistulas (duration 3 months to 3 years) after gastrostomy tube removal were treated endoscopically by electrocautery of the tract and application of metal clips.
  
  
  METHODS
  Treatment resulted in complete fistula closure in two patients and partial closure in a third patient.
  
  
  CONCLUSIONS
  Combined endoscopic therapy with electrocautery and clipping may be an alternative to surgical closure of chronic gastrocutaneous fistulas.
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Monmouth Medical Center, Long Branch, New Jersey, USA.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Teitelbaum
authors.forename: Steven A
authors.initials: SA
authors.lastname: Gorcey
authors.forename: Victor L
authors.initials: VL
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D002425:Cautery / Q000379:methods*; D002675:Child, Preschool; D002908:Chronic Disease; D003131:Combined Modality Therapy; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D020878:Device Removal / Q000009:adverse effects; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005747:Gastric Fistula / Q000209:etiology / Q000601:surgery*; D005773:Gastroscopy / Q000379:methods*; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology