Percutaneous endoscopic gastrostomy: Experience in a secondary level hospital

Yıl 2018, Cilt: 26 Sayı: 3, 95 - 98, 28.12.2018

Abdullah Şenlikçi Ufuk Barış Kuzu , Fatma Dede Kerime Yüce

https://doi.org/10.17940/endoskopi.502900

Cited By: 3

Öz

Background
and Aims: Percutaneous
endoscopic gastrostomy is the safest approach to enteral feeding in patients
with an intact gastrointestinal system
that cannot be fed orally. In this study, we assessed
percutaneous endoscopic gastrostomy indications, complications, and follow-up
data in our secondary level hospital. Materials
and Methods: This was a retrospective study with patients that had a percutaneous
endoscopic gastrostomy tube placed between September 2016 and October 2017 in the
endoscopic unit at Bitlis State Hospital. Results:
Twenty-six patients were included in the
study. Patients mean age was 64,23 years (18-101). Percutaneous endoscopic
gastrostomy was performed in 11 (42.3%) patients due to cerebrovascular
disease, in 5 (19,23%) patients due to dementia, in 3 (11,53%) patients due to amyotrophic
lateral sclerosis, in 1 (%3,84) patient due to neuro-Behçet's disease, in 1 (3,84%)
patient due to hydrocephalus, in 1(3,84%) patient due to acromegaly, in 1
(%3,84) patient due to electricity burn, in 1 (3,84%) patient due to
Erb-Duchenne Muscular dystrophy, in 1 (%3,84) patient due to cerebral palsy, and
in 1(3,84%) patient due to epidural hemorrhage. The mean follow-up period was
137.65 (4-388) days and 3 (11.53%) patients had complications: tube ejection,
free air in the abdomen, and upper gastrointestinal bleeding. No post-procedural
mortality was observed, at 1-month mortality rate was 3.8%, and the 3-month mortality rate was 26.9%. Conclusion: Percutaneous endoscopic
gastrostomy is the safest type of gastrostomy for enteral feeding. Percutaneous
endoscopic gastrostomy can be performed safely
in secondary level hospitals. 

Anahtar Kelimeler

Percutaneous endoscopic gastrostomy, indication, complication

İkinci basamak hastanede perkütan endoskopik gastrostomi deneyimlerimiz

Öz

Giriş ve Amaç: Perkütan
endoskopik gastrostomi, herhangi bir nedenle oral yoldan beslenemeyen ve gastrointestinal
sistemi sağlam olan hastalarda enteral beslenmenin sağlandığı en güvenli
gastrostomi çeşididir. Bu çalışmadaki amacımız 2. basamak hastanemizdeki perkütan
endoskopik gastrostomi takılma endikasyonlarını, işlem sonrası erken ve geç
dönem komplikasyonlarını ve takipleri ile ilgili verileri sunmaktır. Gereç ve Yöntem: Bitlis
Devlet Hastanesi endoskopi ünitesinde Eylül 2016-Ekim 2017 tarihleri arasında
perkütan endoskopik gastrostomi tüpü takılan hastalar retrospektif olarak
incelendi. Bulgular: Çalışmaya
26 olgu dahil edildi. Olguların yaş ortalaması 64,23 (18-101) idi. Olguların
13'ü erkek ve 13'ü kadın idi. Olguların 11'ine (%42,3) serebrovasküler
hastalık, 5'ine (%19,23) demans, 3'üne (%11,53) amyotrofik lateral skleroz, 1'ine
(%3,84) nöro-Behçet, 1'ine (%3,84) hidrosefali, 1'ine (%3,84) akromegali, 1'ine
(%3,84) elektrik yanığı, 1'ine (%3,84) Erb-Duchanne Musküler distrofisi, 1'ine (%3,84)
serebral palsi ve 1'ine (%3,84) epidural kanama nedeniyle perkütan endoskopik
gastrostomi yapıldı. Olguların ortalama takip süresi 137,65 (4-388) gündür. 2 (%11,53)
olguda erken dönem komplikasyon gözlendi. Bir olguda batın içi serbest hava ve
bir olguda da üst gastrointestinal sistem kanaması gözlendi, ek olarak bir
hastamızda, uyumsuzluk nedeniyle perkütan endoskopik gastrostomi kanülünü
çekerek çıkardığı gözlendi. İşleme bağlı mortalite gözlenmemiştir. 1 aylık
mortalite oranımız %3,8 ve 3 aylık mortalite oranımız ise %26,9'dur. Sonuç: Perkütan
endoskopik gastrostomi enteral beslenme amacıyla yapılan gastrostominin en
güvenilir yoludur. 2. basamak hastanelerde de güvenle uygulanabilir.

Anahtar Kelimeler

Perkütan endoskopik gastrostomi, endikasyon, komplikasyon

Kaynakça

• 1) Kusano C, Yamada N, Kikuchi K, et al. Current status of percutaneous endoscopic gastrostomy (PEG) in a general hospital in Japan: a cross-sectional study. J Rural Med 2016;11:7-10.
• 2) Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980;15:872-5.
• 3) Gundogan K, Yurci AM, Coskun R, et al. Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care hospital in Turkey. Eur J Clin Nutr 2014;68:437-40.
• 4) Makwana HB, Kansal SV, Baldha M, Agarwal S. Percutaneous endoscopic gastrostomy: Four years of experience of general surgery department at a tertiary care center at Surat. Int J Sci Stud 2016;4:171-4.
• 5) Temiz A, Aslan OB, Albayrak Y, et al. Percutaneous endoscopic gastrostomy: indications and complications. Akademik Gastroenteroloji Dergisi 2015;14:113-6.
• 6) Senol Z, Karakas DÖ, Yilmaz I, et al. Perkütan endoskopik gastrostomi tecrübemiz: 64 olgunun değerlendirilmesi. Van Tıp Dergisi 2013;20:52-6.
• 7) Bankhead RR, Fisher CA, Rolandelli RH. Gastrostomy tube placement outcomes: comparison of surgical, endoscopic and laparoscopic methods. Nutr Clin Pract 2005;20:607-12.
• 8) Sit M, Kahramansoy N, Tekelioglu UY, Ocak T. Our experience in percutaneous endoscopic gastrostomy. JAREM 2013;3:66-8.
• 9) Ekin N, Ucmak F, Oruc M, et al. Perkütan endoskopik gastrostomi uygulama sonuçlarımız: 113 olgunun değerlendirilmesi. Dicle Med J 2015;42:346-9.
• 10) Akay MA, Yayla D, Elemen L, et al. Percutaneous Endoscopic Gastrostomy; Experience of two clinics. Sakaryamj 2014;4:70-3.
• 11) Zopf Y, Konturek P, Nuernberger A, et al. Local infection after placement of percutaneous endoscopic gastrostomy tubes: a prospective study evaluating risk factors. Can J Gastroenterol 2008;22:987-91.
• 12) Akkersdijk WL, van Bergeijk JD, van Egmond T, et al. Percutaneous endoscopic gastrostomy (PEG): comparison of push and pull methods and evaluation of antibiotic prophylaxis. Endoscopy 1995;27:313-6.
• 13) Sarkar P, Cole A, Scolding NJ, Rice CM. Percutaneous endoscopic gastrostomy tube insertion in neurodegenerative disease: A retrospective study and literature review. Clin Endosc 2017;50:270-8.