CASE REPORT   

Chirurgia 2021 December;34(6):265-8

DOI: 10.23736/S0394-9508.20.05187-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Rare case of gastrocutaneous fistula recurrence treated with laparoscopic approach and absorbable synthetic mesh

Orazio CAPONE ¹ ✉, Chiara AMATUCCI ², Luca P. EVOLI ³, Daniele BRUNELLI ³, Nadia GIULIANI ³, Saverio VALIANI ³, Francesco DINARELLI ³, Giorgio VOLPI ³, Alessandro CONTINE ³, Maurizio CESARI ³

¹ Department of Surgery, Tor Vergata University Hospital, Rome, Italy; ² Department of Surgery, Sapienza University, Rome, Italy; ³ Department of Surgery, Città di Castello Hospital, Città di Castello, Perugia, Italy

A gastrocutaneous fistula (GCF) is a connection from the stomach to the skin. It’s a rare complication after gastric surgery, chronic inflammatory disease, cancer, pancreatic abscess or radiotherapy, but especially after the placement of a PEG-tube. In this case, risk of fistula is directly proportional to the duration of PEG-tube. Gastrocutaneous fistula’s treatments are medical, endoscopic or surgical therapies. We present a case of a 51-year-old man with a recurrent fistula after surgical gastrostomy performed in his childhood due to caustic esophagitis about 50 years ago. After several failed endoscopic approaches, he underwent surgery. Surgical approach is an excision of the fistula tract with a partial gastric resection and an abdominal wall reconstruction with an absorbable synthetic mesh. About abdominal wall reconstruction, contamination can increase the risk of fistula recurrence, postoperative wound infection and developing of incisional hernia, so mesh choice is the key to an acceptable outcome. 1-year follow up showed that our treatment is a safe and feasible choice for abdominal wall reconstruction and it gives good cosmetic results.

KEY WORDS: Fistula; Abdominoplasty; Laparoscopy; Surgical mesh