Site wedge resection technique for gastrostomy tube site revision: A case series

Abstract

Introduction: Gastrostomy tube hypertrophic granulation tissue development, prolapse, and leakage are common problems that are often treated with tube re-siting. Wedge gastrostomy tube site resection is a revision technique used to enable continued use of the original tube site while removing affected tissue. The aim of this study was to describe this technique and outcomes in a series of patients requiring this intervention. The wedge gastrostomy tube site resection involves wedge excision of hypergranulation tissue or prolapsed gastric tissue and primary closure of the remaining defect. We reviewed outcomes for two children who underwent wedge gastrostomy tube site resection for medically refractory hypergranulation tissue. Case presentation: Two patients presented with hypertrophic granulation tissue at their gastrostomy tube sites. In Case 1, the patient underwent two revisions spaced two years apart and has been symptom-free for 9 months. In Case 2, the patient required a single revision and has been symptom-free for 13 months. Neither patient had complications related to their gastrostomy tube site revision in the immediate postoperative period. Conclusion: Wedge gastrostomy tube site resection is a useful strategy to remove reactive tissue that contributes to leakage around a gastrostomy tube and avoids the morbidities of tube re-siting. Level of evidence: IV.

Keywords

• Gastrostomy tube
• Hypertrophic granulation
• Gastric prolapse
• Revision
• Case series