Abstract
[Purpose] A gastrostomy is an essential surgical procedure for pediatric patients with feeding disorders or swallowing dysfunctions. However, some patients requierd remake of gastrostomy due to a intractable leakage of gastric juice through a gastrostomy site. The purpose of the present study was to analyze the causes for leakage of gastric juice in the patients who underwent gastrostomy in our institution.
[Patinets and Methods] A retrospective study was conducted for the 91 patients who underwent a gastrostomy between 1994 and 2010 in our institution. The risk factors such as age, gender, underlying disease and operative procedure were analyzed retrospectively for leakage of gastric juice through the gastrostomy site.
[Results] Five cases (ranged from 2 years to 15 years) of 91 children developed refractory leakage of gastric juice and were indicated for remake of gastrostomy. Initial gastrostomy was made by the method of Stamm with a small laparotomy in all cases. Moreover, the gastrostomy tube was introduced directly into the stomach through the same wound of laparotomy in all cases.
[Conclusions] The gastrostomy tube introduced through the same wound of laparotomy may disturb the normal fistulation and became the cause of thinner abdominal wall resulted in labial fistula due to a wound infection and poor wound healing. Therefore, it is concluded that a gastrostomy tube should be introduced into the stomach through a separate wound from the wound of laparotomy independently.
