ENTERAL BESLENME AMAÇLI PERKUTAN ENDOSKOPİK GASTROSTOMİ UYGULAMALARIMIZ Percutaneous Endoscopic Gastrostomy Applications For Enteral Nutrition

Year 2019, Volume: 9 Issue: 4, 69 - 72, 27.12.2019

Yahya Çelik Ozan Andaç Erbil Tarık Gandi Çinçin Sema Yıldız Yasemin Özkan Fırat Demircan

Abstract

ÖZET
Amaç: Oral yolla yeterli beslenmeyi sağlayamayan hastalarda metabolik gereksinimleri karşılamak için enteral
veya parenteral beslenme yolları kullanılmaktadır. Perkutan endoskopik gastrostomi (PEG), gastrointestinal
sistem fonksiyonları normal olan ve oral yolla beslenemeyen hastalarda uzun süreli enteral beslenme
için tercih edilen bir işlemdir. Amacımız PEG işlemi yaptığımız hastaların sonuçlarını literatür eşliğinde
incelemektir.
Gereç ve Yöntemler: 2012-2018 yılları arasında hastanemiz genel cerrahi endoskopi ünitesinde perkutan
endoskopik gasrostomi tüpü takılan 128 hastanın kayıtları retrospektif olarak incelendi. Hastaların yaşı, cinsiyeti,
işlem tarihi, primer hastalığı (peg endikasyonu) gibi bilgiler ile işlem sonrası gelişen komplikasyonlar
değerlendirildi.
Bulgular: Çalışmaya 52 erkek (%40,63) ve 76 kadın (%59,4) olmak üzere toplam 128 hasta katılmıştır. Hastaların
97’si (%75,8) yatan hasta, 31’ si (%24.2) hasta ayaktan gelen hastalardı. Yatan hastalardan 90 (% 92,8)
yoğun bakım ünitesinde 7(% 7,2) si nöroloji kliniğinde yatmaktadır. PEG takılan hastaların tamamında primer
tanı SVO idi. Majör komplikasyon gelişmedi. Minör komplikasyolar 6 hastada (%4,69) yara enfeksiyonu ve 5
hastada (%3,91) PEG kenarından sızdırma vardır. Bütün hastalar semptomatik tedaviden fayda gördü.
Sonuç: PEG deneyimli ekip tarafından yapıldığı takdirde basit, güvenli, komplikasyon oranı düşük, etkili bir
enteral beslenme yöntemidir. Uygun hastalarda, uzun süreli enteral beslenme için öncelikle başvurulması
gereken beslenme şeklidir.
Anahtar Kelimeler: Endoskopi; Gastrostomi; Teknik; Komplikasyon
ABSTRACT
Aim : In patients with inadequate oral feeding enteral and parenteral feeding are used in order to maintain
metabolic needs. Percutaneous endoscopic gastrostomy is a procedure preferred for long-term enteral
feeding of patients with normal gastrointestinal system functions but unable to get oral feeding. Our aim
is to assess the results of our patients who have undergone PEG procedure in association with literature
review.
Material and method: Patients charts of 128 patients who have undergone percutaneous endoscopic
gastrostomy tube placement in general surgery department of Gebze Kocaeli Fatih State Hospital between
2012- 2018 were retrospectively reviewed. Data such as age and sex of patients, procedure date and primary
disease (indication for PEG) along with complications following the procedure were assessed.
Results: The series consisted from 52 male (40,63%) and 76 female (59,4%) patients totalling 128 patients.
97 (75,8%)of them were inpatients and 31 (24.2%) of them were outpatients. 90 (92.8%) of the inpatients
were staying at intensive care unit and 7 (7.2%) of them were in neurology ward. Primary diagnosis was CVA
in all of the patients with PEG. There was no major complications. And minor complications were wound
infection in 6 patients (4.69%) and leakage from PEG in 5 patients (3.91%). All of the patients benefited from
semptomatic treatment.
Conclusion: PEG is a simple, safe and effective enteral feeding technique with low complication rate when
accomplished by an experienced surgical team. In appropriate patients, it’s a preferential technique for long
term enteral feeding.
Key words: Enteral nutrition; Endoscopy; Gastrostomy; Technique; Complication

Keywords

ENTERAL BESLENME AMAÇLI PERKUTAN ENDOSKOPİK GASTROSTOMİ UYGULAMALARIMIZ Percutaneous Endoscopic Gastrostomy Applications For Enteral Nutrition

References

• 1. Rahnemai-Azar AA, Rahnemaiazar AA, Naghshizadian R, Kurtz A, Farkas DT. Percutaneous endoscopic gastrostomy: indications, technique, complications and management. World Journal of Gastroenterology: WJG. 2014;20(24):7739. 2. Alverdy J, Chi HS, Sheldon GF. The effect of parenteral nutrition on gastrointestinal immunity. The importance of enteral stimulation. Annals of surgery. 1985;202(6):681. 3. Deitch EA, Winterton J, Li M, Berg R. The gut as a portal of entry for bacteremia. Role of protein malnutrition. Annals of surgery. 1987;205(6):681. 4. Strijbos D, Keszthelyi D, Bogie RM, Gilissen LP, Lacko M, Hoeijmakers JG, et al. A Systematic Review and Meta-Analysis on Outcomes and Complications of Percutaneous Endoscopic Versus Radiologic Gastrostomy for Enteral Feeding. Journal of ClinicalGastroenterology. 2018. 5. Endoscopy ASfG. Role of PEG/PEJ in enteral feeding. Gastrointest Endosc. 1998;48(6):69-701. 6. Kirby DF, DeLegge MH, Fleming CR. American Gastroenterological Association technical review on tube feeding for enteral nutrition. Gastroenterology. 1995;108(4):1282-301. 7. Gauderer MW, Ponsky JL, Izant RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. Journal of pediatric surgery. 1980;15(6):872-5. 8. Friginal-Ruiz A, Gonzalez-Castillo S, Lucendo A. Endoscopic percutaneous gastrostomy: an update on the indications, technique and nursing care. Enfermeria clinica. 2011;21(3):173-8. 9. Loser C, Aschl G, Hebuterne X, Mathus-Vliegen E, Muscaritoli M, Niv Y, et al. ESPEN guidelines on artificial enteral nutrition--percutaneous endoscopic gastrostomy (PEG). Clin Nutr. 2005;24(5):848-61. 10. Ekin N, Uçmak F, Oruç M, Tuncer ET, Yalçin K. Perkutan endoskopik gastrostomi uygulama sonuçlarimiz: 113 olgunun degerlendirilmesi/The results of the percutaneous endoscopic gastrostomy insertion: Analysis of 113 cases. Dicle Tip Dergisi. 2015;42(3):346. 11. Tokunaga T, Kubo T, Ryan S, Tomizawa M, Yoshida Si, Takagi K, et al. Long‐term outcome after placement of a percutaneous endoscopic gastrostomy tube. Geriatrics & gerontology international. 2008;8(1):19-23. 12. Ahmad I, Mouncher A, Abdoolah A, Stenson R, Wright J, Daniels A, et al. Antibiotic prophylaxis for percutaneous endoscopic gastrostomy— a prospective, randomised, double‐blind trial. Alimentary pharmacology & therapeutics. 2003;18(2):209-15. 13. Fagundes RB, Cantarelli JC, Fontana K, Motta GL. Percutaneous endoscopic gastrostomy and peristomal infection: an avoidable complication with the use of a minimum skin incision. Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 2011;21(4):275-7.