Laparoscopic management of persistent gastrocutaneous fistula after feeding gastrostomy appliance removal in children

Mohammad Gharieb Khirallah,Nasir Bustangi

doi:10.1186/s43159-020-00057-5

Mohammad Gharieb Khirallah, Nasir Bustangi

Open Access

https://doi.org/10.1186/s43159-020-00057-5

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Abstract

BackgroundFeeding gastrostomy is widely used in children that have troubles of swallowing and need to stablish enteral feeding. There are several methods for creation of that stoma. After the children gain their normal ability of swallowing, this tube or appliance is removed. Failure of spontaneous closure of gastrostomy opening after removal of the tube was reported with an incidence of 0.5 to 3.9%. The purpose of authors was to study laparoscopic management of persistent gastrocutaneous fistula after failure of conservative measures.ResultsThere were 19 patients, 12 males. Main cause for feeding gastrostomy was neurological. Most feeding gastrostomy tubes were inserted endoscopically. The mean operative time was 57 ± 10.2 min. The mean time of full oral intake was 24 ± 3.5 h. No wound infection had developed. There was no recurrence of fistula after management.ConclusionLaparoscopic management of persistent gastrocutaneous fistula is safe, feasible, and associated with no recurrence of fistula.

Highlights

Feeding gastrostomy is widely used in children that have troubles of swallowing and need to stablish enteral feeding
It is expected that spontaneous closure of gastrocutaneous fistula opening takes place within 1 to 3 months after removal of tube or gastric button [4]
The study was carried out on infants and children that suffered from persistent gastrocutaneous fistula after feeding gastrostomy tube removal

Summary

Introduction

Feeding gastrostomy is widely used in children that have troubles of swallowing and need to stablish enteral feeding. Failure of spontaneous closure of gastrostomy opening after removal of the tube was reported with an incidence of 0.5 to 3.9%. There is a wide range of indications for feeding gastrostomy in children. Creation of a stoma for enteral feeding is not free of complications. The incidence of these complications ranges from 2 to 60%. One of these complications is failure of spontaneous closure of gastrostomy opening after removal of tube with an incidence of 0.5 to 3.9% [2, 3]. It is expected that spontaneous closure of gastrocutaneous fistula opening takes place within 1 to 3 months after removal of tube or gastric button [4]

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