Ziya SALİHOĞLU, Osman ESEN, Gülseren YILMAZ, Günsel KUTLUK

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.

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 ofpercutaneous endoscopic gastrostomy (PEG) and opengastrostomy (OG) is limited. The present study aimed tocompare the early post interventional results of patientsundergoing PEG or OG tube insertion.METHODS: Retrospective data regarding the demographicfeatures, interventions, and complications of 70 childrenundergoing gastrostomy tube insertion were obtained frominstitutions digital database. Patients were divided into tworesearch groups according to the technique used ingastrostomy tube placement: group 1 consisted of 40 patientsundergoing OG tube placement under general anesthesia andgroup 2 consisted of 30 patients undergoing PEG tubeplacement with sedation.RESULTS: Overall major complication rate was significantlyhigher in OG patients than PEG patients (28 % vs. 7 %,p=0.032). Bronchospasm (25% vs. 7%, p=0.035) andintraoperative arrhythmias (17% vs. 3 %, p=0.049) were alsomore prevalent in patients receiving OG tube placementcompared to those receiving PEG tube placement. Length ofhospital stay was longer in OG group than that of the PEGgroup (3.8 ± 1.4 days vs. 1.2 ± 0.5 days, p < 0.001).DISCUSSION AND CONCLUSION: In children undergoinggastrostomy tube placement, PEG tube insertion compared toOG tube insertion, is associated with decreased frequency ofintraoperative complications, postoperative majorcomplications and shorter hospital stay. Our results show thatPEG technique with sedation provides better safety profilethan OG in children undergoing gastrostomy tube insertion.

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