Eski Bir Yöntem Olarak Açık Gastrostominin Uygulanabilirliği ve Güvenilirliği

Yıl 2018, Cilt: 2 Sayı: 3, 48 - 52, 29.12.2018

Mesut Yur Erhan Aygen

Öz

Amaç: Enteral nutrisyon için gastrostomi çoğunlukla endoskopik olarak yapılır. Endoskop veya diğer aygıtlar olmadığında veya faringoözofageal
obstrüksiyon olması halinde, açık teknik, lokal anestezi altında minilaparotomi ile uygulanabilir. Biz bu çalışmada, ihtiyaç halinde bu eski tekniğin
güvenilirlik ve uygulanabilirliğini sunmak istedik.

Araçlar ve Yöntem: Bu eski yöntemle 28 hasta opere edildi. Yöntem, ksifoidin hemen altından mini vertikal insizyon (2-3 cm) ile lokal anestezi
altında uygulandı. Gastrostomi tüpü, gastrotomi sonrası direk görüş altında mide duvarından girildi. Mide duvarı çift purse string dikişle dikildi. Tüp
sol subkostal karın duvarından dışarı çıkarıldı. Tüm veriler retrospektif olarak değerlendirildi.

Bulgular: Tüp gastrostomi, lokal anestezi altında minilaparotomi ile kolayca ve güvenle uygulandı. Herhangi bir komplikasyon gözlenmedi.
Ortalama operasyon süresi 36.07 ± 10.18 dakikaydı ve tüm hastalar operasyondan 24 saat sonra beslenmeyi tolere etti.

Sonuç: Minilaparotomi ile lokal anestezi altında yapılan tüp gastrostomi, ihtiyaç halinde güvenle ve kolayca yapılabilir. Bu eski tekniği, endoskop,
diğer enstrümanlar olmadığında veya özefagus obstrüksiyonu durumunda kullanabiliriz. Her ne kadar lokal anestezi altında minilaparotomi ile tüp
gastrostomi uygulaması kolay ve güvenli olsa da, tüp gastrostomiler için endoskopik yöntemler kullanılmalıdır.  

Anahtar Kelimeler

Gastrostomi, laparotomi, nütrisyon

Feasibility and Reliability of Open Gastrostomy as an Old Method

Öz

Purpose: Gastrostomy for enteral nutrition is often performed endoscopically. If an
endoscope or other instruments are not available or a pharyngoesophageal
obstruction is seen, an open gastronomy technique can beuseful under local
anesthesia using minilaparotomy. In this study, we aim to present the feasibility and reliability of this old
method when needed.

Materials and Methods: Twenty-eight patients were operated on using this old technique. The
operations were performed under local anesthesia with
a mini vertical incision (2-3 cm) just below the xiphoid process. A gastrostomy
tube was inserted through the gastric wall under direct vision after the gastrotomy. The gastric wall was fastened with
double-purse string sutures. The tube was taken out from the left subcostal
gastric wall. All the data were evaluated
retrospectively.

Results: A tube gastrostomy was performed easily and safely in all patients under
local anesthesia by way of a minilaparotomy. There were no observed complications. The mean operative time was 36.07 ±
10.18 minutes and all the patients tolerated feeding within 24 hours of the
operation.

Conclusion: A tube gastrostomy can be performed safely and easily under local
anesthesia by way of a minilaparotomy when necessary. We can use this old technique when we don’t have an endoscope, other
instruments or in case of an esophageal obstruction. Although this technique is
safe and easy to perform, endoscopic methods
should be used for tube gastrostomies.  

Anahtar Kelimeler

Gastrostomy, laparotomy, nutrition

Kaynakça

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