Perkütan endoskopik gastrostomi uyguladığımız hastalarda uzun dönem sonuçlarımız
Amaç: Oral gıda alamayan, özellikle yoğun bakım ünitelerinde yatmakta olan hastalara enteral beslenme desteği sağlamak amacıyla minimal invaziv bir metod olan perkutan endoskopik gastrostomi (PEG) deneyimimizi sunmayı amaçladık. Gereç ve yöntem: Bu çalışmada kliniğimizde Ocak 2000 - Haziran 2010 tarihleri arasında en az 4 hafta süreyle oral beslenemeyeceği öngörülerek PEG yerleştirilen 700 olgu retrospektif olarak incelendi. Hasta kayıtları endikasyonlar, komplikasyonlar ve sonuçları açısından değerlendirildi. Bulgular: Hastaların 400\' (% 57) ü erkek, 300\' ü (%43) bayandı. Olguların büyük çoğunluğu nörolojik nedenli patolojilerdi. Tüm hastalarda beslenme problemi vardı. PEG sonrası 50 (%7.1) hastada cilt altı infeksiyonu, 18 (%2.5) hastada PEG kenarından kaçak, 16 (%2.0) hastada PEG kenarından kanama görüldü. Sonuç: PEG, minimal invaziv bir girişim ile yapılabilmesi, mortalite ve morbiditesinin çok az olması nedeniyle yoğun bakım hastaları için basit, emniyetli ve etkili bir beslenme yöntemidir.
Long-term results of percutaneous endoscopic gastrostomies
Objectives: In order to provide enteral nutrition for patients in intensive-care units who cannot be fed orally, we aimed to present our percutaneous endoscopic gastrostomy (PEG) experience, which is a minimally invasive method. Materials and methods: In this study, 700 patients who applied to our clinic between January 2000 and June 2011 and who had a PEG because they could not be fed orally were retrospectively assessed in terms of indications, complications, and results. Results: Among these patients, 400 (57%) were male and 300 (43%) were female. Most of the patients with feeding problems had also neurologically caused pathologies. After the PEG, 50 (7.1%) patients had under-skin infections, 18 (2.5%) patients had leakage from the edge of the PEG, and 16 (2.0%) patients had bleeding from the edge of the PEG. Conclusion: PEG is a secure and effective nutrition method as it can be performed with a minimally invasive procedure and it has low mortality and morbidity.
___
- Hamidon BB, Abdullah SA, Zawawi MF, Sukumar N, Ami- nuddin A, Raymond AA. A prospective comparison of per- cutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke. Med J Ma- laysia 2006;61(1):59-66.
- Cantwell CP, Gervais DA, Hahn PF, Mueller PR. Feasibil- ity and safety of infracolic fluoroscopically guided per- cutaneous radiologic gastrostomy. J Vasc Interv Radiol 2008;19(1):129-32.
- Gauderer MW, Ponsky JL, Izant RJ Jr.Gastrostomy without laparotomy: a percutaneous endoscopic technique. 1980. Nutrition 1998;14(9):736-8.
- Nicholson FB, Korman MG, Richardson MA. Percutaneous endoscopic gastrostomy: a review of indications, complica- tions and outcome. J Gastroenterol Hepatol 2000;15(1):21- 5.
- Rabeneck L, Wray NP, Petersen NJ. Long-term outcomes of patients receiving percutaneous endoscopic gastrostomy tubes. J Gen Intern Med 1996;11(5):287-93.
- Stockeld D, Fagerberg J, Granström L, Backman L. Percuta- neous endoscopic gastrostomy for nutrition in patients with oesophageal cancer. Eur J Surg 2001;167(11):839-44.
- Potochny JD, Sataloff DM, Spiegel JR, Lieber CP, Siskind B, Sataloff RT. Head and neck cancer implantation at the per- cutaneous endoscopic gastrostomy exit site. A case report and a review. Surg Endosc 1998;12(11):1361-5.
- Saadeddin A, Freshwater DA, Fisher NC, Jones BJ. Antibi- otic prophylaxis for percutaneous endoscopic gastrostomy for non-malignant conditions: a double-blind prospec- tive randomized controlled trial. Aliment Pharmacol Ther 2005;22(6):565-70.
- Robins G, Hull M. Antibiotic prophylaxis for percutaneous endoscopic gastrostomy insertion in patients with non-ma- lignant disease. Aliment Pharmacol Ther 2006;23(8):1276- 7; author reply 1277.
- Sturgis TM, Yancy W, Cole JC, Proctor DD, Minhas BS, Marcuard SP. Antibiotic prophylaxis in percutaneous endo- scopic gastrostomy. Am J Gastroenterol 1996;91(11):2301- 4.
- Rey JR, Axon A, Budzynska A, Kruse A, Nowak A. Guide- lines of the European Society of Gastrointestinal Endosco- py (E.S.G.E.) antibiotic prophylaxis for gastrointestinal en- doscopy. European Society of Gastrointestinal Endoscopy. Endoscopy 1998;30(3):318-24.
- Hameed H, Khan YI.Metastasis of carcinosarcoma of oe- sophagus to gastrostomy site. Br J Oral Maxillofac Surg 2009;47(8):643-4.
- Vatansev C, Aksoy F, Belviranlı M, Yosunkaya A, Özer S. Yoğun bakım hastalarında perkütan endoskopik gastrosto- mi. Endoskopik Laparoskopik ve Mminimal İnvaziv Cerra- hi 2002;9(4):69-72.
- Stein J, Schulte-Bockholt A, Sabin M, Keymling M. A ran- domized prospective trial of immediate vs. next-day feed- ing after percutaneous endoscopic gastrostomy in intensive care patients. Intensive Care Med 2002;28(11):1656-60.