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Persistent gastrocutaneous fistula: factors affecting the need for closure.
Wyrick, Deidre L; Bozeman, Andrew P; Smith, Samuel D; Jackson, Richard J; Maxson, R Todd; Kelley, Karen R; Mathews, Donna L; Li, Jingyun; Swearingen, Christopher J; Dassinger, Melvin S.
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  • Wyrick DL; Department of Pediatric Surgery, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 1 Children's Way, Slot 837, Little Rock, AR, USA. Electronic address: dlwyrick@uams.edu.
J Pediatr Surg ; 48(12): 2506-10, 2013 Dec.
Article en En | MEDLINE | ID: mdl-24314194
PURPOSE: The occurrence of gastrocutaneous fistula (GCF) is a well-known complication after gastrostomy tube placement. We explore multiple factors to ascertain their impact on the rate of persistent GCF formation. METHODS: We retrospectively reviewed patient records for all gastrostomies (GT) constructed at our institution from 2007 to 2011. Association of GCF with method of placement, concomitant fundoplication, neurologic findings, duration of therapy, and demographics was evaluated using logistic regression. RESULTS: Nine hundred fifty patients had GTs placed, of which 148 patients had GTs removed and 47 (32%) of 148 required surgical closure secondary to persistent GCF. Laparoscopic and open procedures comprised 79 (53%) of 148 and 69 (47%) of 148, respectively. Seventeen (22%) patients in the laparoscopic group developed persistent GCF, compared to 30 (43%) in the open group (P=0.035, OR=2.52). Seventy-one patients had concomitant Nissen fundoplication. Thirty-one (44%) developed GCF, compared to 16 (21%) without a Nissen (P=0.002, OR=4.94). Patients with button in place for 303 days had persistent GCF incidence of 23%, compared to 45% at 540 days (P<0.001, OR=3.51) and 50% at 850 days (P=0.011, OR=4.51). Patients with device placed at 1.8 months of age were more likely to develop GCF compared to those with device placed at 8.9 months of age (P=0.017, OR=2.35). CONCLUSION: Open operations, concurrent Nissen and younger age at placement were all statistically significant factors causing persistent GCF.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Gastrostomía / Fístula Gástrica / Laparoscopía / Fístula Cutánea / Fundoplicación Tipo de estudio: Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Pediatr Surg Año: 2013 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Gastrostomía / Fístula Gástrica / Laparoscopía / Fístula Cutánea / Fundoplicación Tipo de estudio: Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Pediatr Surg Año: 2013 Tipo del documento: Article Pais de publicación: Estados Unidos