A Prospective Evaluation of Non-Operative Treatments for Gastrocutaneous Fistulae Closure in Children

jpedsurg.org

Gastrocutaneous fistulae (GCF) persist after gastrostomy removal in one third of children. Several non-surgical treatment options have been described, including the use of proton-pump inhibitors, topical fibrin glue, silver nitrate application, and collagen plugging, albeit in underpowered and uncontrolled studies. We evaluated the efficacy and tolerability of a standardized, “bundled” regimen of non-surgical therapies given immediately after gastrostomy tube removal to promote closure.

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Article · Sep 2025 · 1 min read

In brief

This prospective study evaluates a standardized bundle of non-surgical interventions—including proton-pump inhibitors, fibrin glue, silver nitrate, and collagen plugging—to promote closure of gastrocutaneous fistulae after gastrostomy tube removal in pediatric patients. The research addresses a common complication affecting one-third of children post-gastrostomy, offering evidence for conservative management strategies.

Gastrocutaneous fistulae persist in 33% of pediatric patients after gastrostomy tube removal
Non-surgical treatment bundle includes PPIs, fibrin glue, silver nitrate, and collagen plugging
Standardized protocol applied immediately post-removal may improve closure rates
Prior studies of individual therapies were underpowered and lacked controls
Bundled approach addresses need for evidence-based GCF management in children

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