Punch Excision of Epithelialized Tracts for Gastrocutaneous
Persistent gastrocutaneous fistula (GCF) is a common problem encountered in the pediatric population. According to the research, the Punch Excision of Epithelialized Tracts (PEET) shows short-term efficacy.

Several management options for intervening on pediatric persistent GCF have been described and range from open surgical management to medical management. In this study, researchers describe a novel adaptation on a previously described technique that utilizes a punch biopsy to excise the GCF they have coined as Punch Excision of Epithelialized Tracts (PEET).

The steps to this procedure include passing a punch biopsy tool over a Foley catheter. The catheter is inserted into the GCF tract, the balloon is inflated, the catheter is retracted against the abdominal wall, and the punch biopsy instrument is pushed through the skin and subcutaneous tissue circumferentially excising the tract.

Four patients at the institution have undergone GCF excision using the PEET approach. The mean duration of the GCF in four patients was 9 months. Mean follow-up after GCF excision using the PEET approach was 7.8 months. No patients in the cohort had any post-operative complications including surgical site wound infection, emergency department visits, or re-hospitalizations related to their surgical care.

Based on our preliminary findings in this small patient cohort, researchers believe the PEET approach for managing persistent pediatric GCF has short-term efficacy and has the potential upside of utilizing fewer hospital resources to perform the procedure in a time-efficient manner.

Journal of Pediatric Surgery
Source: https://doi.org/10.1016/j.jpedsurg.2021.06.002