Perkütan Endoskopik Gastrostomi Deneyimi: Erken ve Geç Dönem Komplikasyonlar

Abstract

Amaç Bu çalışmada perkütan endoskopik gastrostomi (PEG) tüpü yerleştirilen hastaların erken ve geç komplikasyonları retrospektif olarak değerlendirilmiş, farklı hastalıkların komplikasyon sıklığı tartışılmış ve son olarak komplikasyonların azaltılması için bazı önerilerde bulunulmuştur. Yöntemler Çalışma, bir eğitim ve araştırma hastanesinin endoskopi ünitesinde PEG tüpü yerleştirilen 99 hasta ile yürütülmüştür. Hastaların yaşı, cinsiyeti, tanısı, erken ve geç komplikasyon türleri ve komplikasyon gelişme oranları değerlendirilmiştir. Bulgular Hastaların ortalama yaşı 70,42±16,75 (18-94) yıl olup %48,5'i erkekti. Erken komplikasyonlar %11,1 oranında görülmüş olup, bunların %6,05'i PEG tüpünün giriş yerinde kanama ve %5,05'i peristomal enfeksiyondur. Hastaların %39,4'ünde geç komplikasyonlar görüldü; bunların %18'i tüpün yerinden çıkması, %8,1'i enfeksiyon, %7,1'i aspirasyon pnömonisi ve %6'sı diğer komplikasyonlardı. Hastaların %51,5'inde herhangi bir komplikasyon gözlenmezken, %48,5'inde erken veya geç komplikasyon gözlenmiştir. Hastaların %2'sinde hem erken hem de geç komplikasyon görüldü. Geç komplikasyon insidansı Alzheimer hastalığı olan hastalarda anlamlı olarak daha yüksekti (p=0,027). Sonuç Son altı ay içinde PEG tüpü takılan hastaların takibinde en sık görülen erken komplikasyon %6,05 ile kanama, en sık görülen geç komplikasyon ise %18 ile tüpün yerinden çıkması olmuştur. Potansiyel komplikasyonlarına rağmen, PEG tüpü uzun süreli enteral beslenme için güvenli bir yöntemdir. Alzheimer hastaları geç komplikasyonlar açısından diğer hastalıklara göre daha fazla risk altındadır.

Keywords

• Enteral beslenme
• Perkütan endoskopik gastrostomi
• Erken komplikasyonlar
• Geç komplikasyonlar

Percutaneous Endoscopic Gastrostomy Experience: Early and Late Complications

Abstract

Purpose: This study retrospectively evaluated the early and late complications of patients who had a percutaneous endoscopic gastrostomy (PEG) tube placed, discussed complication frequency of different diseases and finally pointed on some advices to reduce complications. Method: The study was conducted with 99 patients who had a PEG tube placed in the endoscopy unit of a training and research hospital. Patients’ age, gender, diagnosis, types of early and late complications, and complication development rates were evaluated. Results: Mean age of the patients was 70.42±16.75(18-94) years and 48.50% were male. Early complications occurred in 11.10%, of which 6.05% were bleeding at the entry site of the PEG tube, and 5.05% were peristomal infection. 39.40% of the patients had late complications, including tube dislodgement in 18%, infection in 8.10%, aspiration pneumonia in 7.10% and other complications in 6%. No complications were observed in 51.50% of the patients, and early or late complications were observed in 48.50% of the patients. 2% of the patients had both early and late complications. The incidence of late complications was significantly higher in patients with Alzheimer’s disease (p=0.027). Conclusion: In the follow-up of patients who had a PEG tube placed in the previous six months, the most common early complication was bleeding in 6.05%, and the most common late complication was tube dislodgement in 18%. Despite its potential complications, the PEG tube is a safe method for long-term enteral feeding. Alzheimer patients are at risk for late complications more than other diseases.

Keywords

• Enteral feeding
• Percutaneous endoscopic gastrostomy
• Early complications
• Late complications

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