Perkütan radyolojik gastrostomi ve gastrojejunostomi: Uzun dönem enterik beslenmede alternatif bir yöntem

Amaç: Bu çalışmada perkütan radyolojik gastrostomi ve gastrojejunostominin güvenlik ve teknik başarısının araştırılması amaçlanmıştır. Gereç ve Yöntem: Perkütan gastrostomi ya da gastroje-junostomi uygulanmış olan 35 hastanın sonuçları retros-pektif olarak incelendi. İşlem için endikasyonlar, 22 olguda santral sinir sistemi patolojisine bağlı yutma bozukluğu, 8 olguda orofaringeal problemler nedeniyle beslenememe ve 5 olguda gastrointestinal sistem disfonksiyonu nedeniyle aşırı kilo kaybı idi. Aspirasyon, diyafragma hernisi ya da gastroözofagial reflü öyküsü olan olgulara perkütan gastrojejunostomi uygulandı. Bulgular: Perkütan radyolojik gastrostomi 22 olguda, gastrojenunostomi ise 11 olguda uygulandı. Bir olguda kolonun mide üzerine süperpoze olması nedeniyle emniyetli giriş penceresi bulunamadığından işlem gerçekleştirilmedi. Bir olguda ise girişim yapılmasına karşın işlem başarılı olmadı. İşlem sonrasında 2 olguda tüp dislokasyonu ve 1 olguda giriş yeri akıntısı olmak üzere toplam 3 olguda (% 9) minör komplikasyon görüldü. İşlem sonrasında majör komplikasyon ve 30 günlük mortalite bir olguda (% 3) görüldü. Sonuç: Perkütan radyolojik gastrostomi ve gastrojejunostomi, yüksek teknik başarı ve düşük komplikasyon oranları ile etkin ve güvenli yöntemlerdir. Özellikle çeşitli nedenlerle endoskopi yapılamayan olgularda uzun dönemli enterik beslenme için perkütan radyolojik gastrostomi yöntemi tercih edilebilir.

Percutaneous radiological gastrostomy and gastrojejunostomy: An alternative method for long term enteric feeding

Objectives: In this study it was aimed to investigate the safety and technical success of percutaneous radiological gastrostomy and gastrojejunostomy. Materials and Methods: Results of 35 patients with a percutaneous gastrostomy or gastrojejunostomy are ret- rospectively evaluated. The indications for the procedure were dysphagia due to central nervous system disorders in 22, feeding disturbance due to oropharyngeal problems in 8 and excessive weight loss secondary to gastrointes- tinal system dysfunction in 5. The indications for percu- taneous gastrojejunostomy were a history of aspiration, gastroesophageal reflux and diaphragmatic hernia. Results: Percutaneous radiological gastrostomy was per- formed in 22 and percutaneous gastrojejunostomy in 11 patients. In one patient, the procedure was not performed because of colonic superposition on the entire stomach, which precluded a safe access route. In another patient intervention was not successful. Minor complications, consisting of tube dislocation (n=2) and access site drain- age (n=1) were seen in 3 (9%) patients. Major complica- tions and 30 day mortality occurred in one (3%) patient. Conclusions: Percutaneous radiological gastrostomy and gastrojejunostomy are safe and effective methods with high technical success and low complication rates. Percutaneous radiological gastrostomy may be the meth- od of choice for long term enteric feeding in patients, in whom endoscopy cannot be performed.

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