Tuğrul TİRYAKİ, Ziya LİVANELİOĞLU, Emrah ŞENEL, Fatih AKBIYIK, Halil ATAYURT

Beslenme Jejunostomisi; Özofagus Atrezili Olguların Tedavisinde Hayat Kurtarıcı Bir Uygulama

Amaç: Özofagus atrezisi onarımı sırasında beslenme jejunostomisi uygulamasının güvenilirliği, etkinliği ve komplikasyonlarının geriye dönük olarak değerlendirilmesi amaçlanmıştır. Metod: Çalışmamıza özofagus atrezisi onarımı sırasında primer gecikmiş onarım ve anastomoz sızdırması nedeni ile Witzel jejunostomi uygulaması yapılan 11 olgu alınmıştır. Olgularımız beslenme ve beslenmeyi tolere etme, iyileşme, kilo alma ve komplikasyonlar açısından değerlendirilmiştir. Bulgular: İki olguda beslenme sırasında kateter tıkanıklığı saptandı. Sekiz olguda yeterli kalori alımı beslenmeye başlamanın dördüncü gününde gerçekleşti. Üç olguda infüzyon hızını düşürerek izlemi gerektiren minör gastrointestinal komplikasyon gelişti. Olgularımız jejunostomi beslenmesinde ile ortalama 24 gün (14-45 gün) kaldılar. Hiçbir olguda tekrar kateter takılmasını gerektirecek ciddi bir komplikasyon gelişmedi. Beslenme jejunostomisine bağlı komplikasyondan kaybedilen hasta olmadı. Sonuçlar: Witzel tüp jejunostomi uygulaması özofagus atrezisi nedeni ile opere edilen olgularda beslenmenin sağlanması için etkili bir yöntemdir. Özofagusta yapılan anastomoza bağlı komplikasyon oluşan ya da gecikmiş primer onarım yapılacak olan hastalarda uzamış enteral beslenme bu yolla sağlanabilir. Bu tip olguların tedavisinde destekleyici önemli bir role sahiptir.

Anahtar Kelimeler:

Beslenme jejunostomisi, özofagus atrezisi

FEEDING JEJUNOSTOMY; A LIFE SAVING PROCEDURE IN THE TREATMENT OF PATIENTS WITH ESOPHAGEAL ATRESIA

Purpose: Retrospective evaluation of the reliability, efficiency and complications of the feeding jejunostomy application in esophageal atresia repair is aimed. Method: 11 cases on whom Witzel jejunostomy is applied for delayed primary repair and anastomotic leakage in esophageal atresia treatment are included in our study. Our cases are evaluated on the basis of nutrition and tolerating the nutrition, recovery, gaining weight and complications. Findings: Catheter obstruction in the course of feeding was encountered in two cases. Adequate calory intake was realized on the fourth day of the feeding in eight cases. In three cases minor gastrointestinal complications developed which only required following by reduction of infusion speed. Our cases were kept on jejunostomy feeding for 24 days on average (14 to 45 days). In non of the cases a serious complication requiring a new catheter replacement developed. None of the patients were lost due to the complications of the feeding jejunostomy. Results: Witzel tube jejunostomy application is an effective method to maintain feeding in cases operated for esophageal atresia. Enteral feeding can be obtained by this way in patients with anastomotic complications or when delayed primary repair has to be done. It has a cardinal supportive role in the treatment of these kind of cases

Keywords:

Feeding jejunostomy, esophageal atresi,

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