Gülseren YILMAZ, Günsel KUTLUK, Osman ESEN, ZİYA SALİHOĞLU

Comparison of Safety Profile of Percutaneous Endoscopic Gastrostomy & Open Gastrostomy in Children Undergoing Gastrostomy Tube Insertion

INTRODUCTION: Current data comparing advantages, disadvantages and early post interventional complications of percutaneous endoscopic gastrostomy (PEG) and open gastrostomy (OG) is limited. The present study aimed to compare the early post interventional results of patients undergoing PEG or OG tube insertion. METHODS: Retrospective data regarding the demographic features, interventions, and complications of 70 children undergoing gastrostomy tube insertion were obtained from institutions digital database. Patients were divided into two research groups according to the technique used in gastrostomy tube placement: group 1 consisted of 40 patients undergoing OG tube placement under general anesthesia and group 2 consisted of 30 patients undergoing PEG tube placement with sedation. RESULTS: Overall major complication rate was significantly higher in OG patients than PEG patients (28 % vs. 7 %, p=0.032). Bronchospasm (25% vs. 7%, p=0.035) and intraoperative arrhythmias (17% vs. 3 %, p=0.049) were also more prevalent in patients receiving OG tube placement compared to those receiving PEG tube placement. Length of hospital stay was longer in OG group than that of the PEG group (3.8 ± 1.4 days vs. 1.2 ± 0.5 days, p < 0.001). DISCUSSION AND CONCLUSION: In children undergoing gastrostomy tube placement, PEG tube insertion compared to OG tube insertion, is associated with decreased frequency of intraoperative complications, postoperative major complications and shorter hospital stay. Our results show that PEG technique with sedation provides better safety profile than OG in children undergoing gastrostomy tube insertion.

Gastrostomi Tüpü Yerleştirilen Çocuklarda Perkütan Endoskopik Gastrostomi ve Açık Gastrostominin Güvenlik Profillerinin Karşılaştırılması

GİRİŞ ve AMAÇ: Perkütan endoskopik gastrostomi (PEG) ve açık gastrostominin (AG) avantaj, dezavantaj ve erken komplikasyonlarını karşılaştıran güncel çalışma sayısı azdır. Bu çalışma iki yöntemin erken sonuçlarını karşılaştırmayı amaçlamaktadır. YÖNTEM ve GEREÇLER: Gastrostomi tüpü yerleştirilen 70 pediatrik hastaya ait demografik bilgiler, uygulanan girişimler ve komplikasyonlar hastan bilgi işlem sisteminden derlendi. Hastalar sedasyon altında PEG uygulanan (30 hasta) ya da genel anestezi altında AG uygulananlar (40 hasta) olmak üzere iki gruba ayrıldı. BULGULAR: AG uygulanan hastalarda PEG uygulananlarla kıyaslandığında toplam major komplikasyon oranı daha fazlaydı (% 28’ e karşı % 7, p=0.032). Bronkospazm (% 25’ e karşı % 7, p=0.035) ve inatraoperatif aritmiler (% 17’ e karşı % 3, p=0.049) AG grubunda PEG grubuna göre daha sıktı. AG uygulanan hastalarda hastanede yatış süresi PEG uygulanan hastalara kıyasla anlamlı olarak daha yüksekti (3.8 ± 1.4 güne karşı 1.2 ± 0.5 gün, p < 0.001). TARTIŞMA ve SONUÇ: Gastorostomi tüpü yerleştirilen hastalarda PEG ile tüp yerleştirilmesi AG ile tüp yerleştirilmesine kıyasla azalmış intraoperatif komplikasyona oranı, azalmış postoperatif komplikasyon oranı ve daha kısa hastane yatış süresi ile ilişkilidir. Çalışmamızın sonuçları, sedasyon altında PEG ile gastrostomi tüpü yerleştirilmesinin genel anestezi altında AG ile tüp yerleştirilmesinden daha güvenli olduğunu göstermektedir.

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