Percutaneous radiological gastrostomy and gastrojejunostomy: An alternative method for long term enteric feeding

Yıl 2012, Cilt: 39 Sayı: 4, 518 - 523, 01.12.2012

Aslıhan Semiz Oysu Yaşar Bükte

https://doi.org/10.5798/diclemedj.0921.2012.04.0193

Öz

Objectives: In this study it was aimed to investigate the safety and technical success of percutaneous radiological gastrostomy and gastrojejunostomy. Materials and Methods: Results of 35 patients with a percutaneous gastrostomy or gastrojejunostomy are retrospectively evaluated. The indications for the procedure were dysphagia due to central nervous system disorders in 22, feeding disturbance due to oropharyngeal problems in 8 and excessive weight loss secondary to gastrointestinal system dysfunction in 5. The indications for percutaneous gastrojejunostomy were a history of aspiration, gastroesophageal reflux and diaphragmatic hernia. Results: Percutaneous radiological gastrostomy was performed in 22 and percutaneous gastrojejunostomy in 11 patients. In one patient, the procedure was not performed because of colonic superposition on the entire stomach, which precluded a safe access route. In another patient intervention was not successful. Minor complications, consisting of tube dislocation (n=2) and access site drainage (n=1) were seen in 3 (9%) patients. Major complications and 30 day mortality occurred in one (3%) patient. Conclusions: Percutaneous radiological gastrostomy and gastrojejunostomy are safe and effective methods with high technical success and low complication rates. Percutaneous radiological gastrostomy may be the method of choice for long term enteric feeding in patients, in whom endoscopy cannot be performed.

Anahtar Kelimeler

Gastrostomy, gastrojejunostomy, percutaneous intervention, interventional radiology, enteral feeding.

Perkütan radyolojik gastrostomi ve gastrojejunostomi: Uzun dönem enterik beslenmede alternatif bir yöntem

Öz

Amaç: Bu çalışmada perkütan radyolojik gastrostomi ve gastrojejunostominin güvenlik ve teknik başarısının araştırılması amaçlanmıştır. Gereç ve Yöntem: Perkütan gastrostomi ya da gastrojejunostomi uygulanmış olan 35 hastanın sonuçları retrospektif olarak incelendi. İşlem için endikasyonlar, 22 olguda santral sinir sistemi patolojisine bağlı yutma bozukluğu, 8 olguda orofaringeal problemler nedeniyle beslenememe ve 5 olguda gastrointestinal sistem disfonksiyonu nedeniyle aşırı kilo kaybı idi. Aspirasyon, diyafragma hernisi ya da gastroözofagial reflü öyküsü olan olgulara perkütan gastrojejunostomi uygulandı. Bulgular: Perkütan radyolojik gastrostomi 22 olguda, gastrojenunostomi ise 11 olguda uygulandı. Bir olguda kolonun mide üzerine süperpoze olması nedeniyle emniyetli giriş penceresi bulunamadığından işlem gerçekleştirilmedi. Bir olguda ise girişim yapılmasına karşın işlem başarılı olmadı. İşlem sonrasında 2 olguda tüp dislokasyonu ve 1 olguda giriş yeri akıntısı olmak üzere toplam 3 olguda (% 9) minör komplikasyon görüldü. İşlem sonrasında majör komplikasyon ve 30 günlük mortalite bir olguda (% 3) görüldü. Sonuç: Perkütan radyolojik gastrostomi ve gastrojejunostomi, yüksek teknik başarı ve düşük komplikasyon oranları ile etkin ve güvenli yöntemlerdir. Özellikle çeşitli nedenlerle endoskopi yapılamayan olgularda uzun dönemli enterik beslenme için perkütan radyolojik gastrostomi yöntemi tercih edilebilir.

Anahtar Kelimeler

Gastrostomi, gastrojejunostomi, perkütan girişim, girişimsel radyoloji, enterik beslenme.

Kaynakça

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