Alshafei Abdulrahman, Deacy Dawn, Antao Brice
Department of Paediatric Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.
J Indian Assoc Pediatr Surg. 2017 Oct-Dec;22(4):220-225. doi: 10.4103/jiaps.JIAPS_205_16.
The aim of this study is to identify the risk factors for a persistent gastrocutaneous fistula (GCF) after gastrostomy device (GD) removal in children.
A retrospective analysis of 59 patients that underwent GD insertion and removal over an 11-year period (2005-2015). Patients were divided into two Groups (A and B) according to persistence or closure of the gastrocutaneous tract. Data included patient demographics, comorbidities, age at insertion, gastrostomy site infections, size and type of device, duration of placement, and method of insertion and removal. Statistical analysis was done using Chi-square test and ANOVA test where < 0.05 was considered statistically significant.
A total of 34 patients (Group A) developed a GCF post-GD removal. The gastrostomy tract closed spontaneously in 25 patients (Group B). Underlying comorbidities did not influence spontaneous closure. Younger age at insertion (<2 years), longer duration of device placement, open gastrostomy insertion, upsizing the GD, changing a gastrostomy tube to a button, and site infections were significant risk factors for a persistent GCF.
Risk analysis of persistent GCF is important for patient counseling before removal or replacement of the GD. We have identified a number of potentially reversible risk factors for a persistent GCF and have made recommendations accordingly.
本研究旨在确定儿童胃造口装置（GD）移除后持续性胃皮肤瘘（GCF）的危险因素。
对59例在11年期间（2005 - 2015年）接受GD置入和移除的患者进行回顾性分析。根据胃皮肤通道的持续性或闭合情况将患者分为两组（A组和B组）。数据包括患者人口统计学资料、合并症、置入时年龄、胃造口部位感染、装置尺寸和类型、放置持续时间以及置入和移除方法。使用卡方检验和方差分析进行统计分析，P < 0.05被认为具有统计学意义。
共有34例患者（A组）在GD移除后发生GCF。25例患者（B组）的胃造口通道自发闭合。潜在合并症不影响自发闭合。置入时年龄较小（<2岁）、装置放置持续时间较长、开放式胃造口置入、增大GD尺寸、将胃造口管更换为纽扣以及部位感染是持续性GCF的显著危险因素。
持续性GCF的风险分析对于在移除或更换GD之前为患者提供咨询很重要。我们已经确定了一些持续性GCF的潜在可逆危险因素，并据此提出了建议。
