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PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL

Yıl 2023, Cilt: 4 Sayı: 1, 6 - 10, 29.03.2023
https://doi.org/10.48176/esmj.2023.96

Öz

Introduction: The aim of this study was to determine the indications of Percutaneous endoscopic gastrostomy (PEG) patients treated in a secondary state Burdur hospital over a period of three years, the unit where the patient was hospitalized, survival time with PEG therapy, and the complications observed in these patients.
Methods: Patients who underwent PEG in the endoscopy unit of our hospital, between January 2019 and January 2022, were retrospectively evaluated. Age, gender, the unit of inpatient, indications
for PEG therapy, complications after PEG, and survival status of the patients were recorded in the form of case reports. Patients with coagulation disorders, hemodynamic instability, peritonitis, sepsis, infection at the insertion area, peritonitis carcinomatosis, a history of total gastrectomy and gastric varices were excluded.
Results:The median age of the 120 patients included in the study was 79 (17–100) years, and 66 (55%) of the patients were male. Complications were observed in 14 (11.7%) patients, all of which
were minor, including seven (5.8%) PEG site infections, three (2.5%) PEG site leakages, three (2.5%) PEG occlusions, and one (0.9%) PEG removal. It was determined that 73 (60.8%) patients survived
at least 30 days; the patients were most frequently referred by the neurology unit, with a rate of 52.7%. The most common indications for PEG insertion were cerebrovascular disease (56.7%) and dementia (29.2%).
Conclusion: Maintenance of nutritional requirements via PEG allows for the preservation of mucosal integrity and barrier function, intestinal immune response, and normal flora. It is superior to other enteral feeding methods due to the lower risk of aspiration. In conclusion, our study, which presented the experiences of the PEG insertion and therapy in a secondary state hospital, stated that the complication rates, indications, and referring clinics were found to be consistent with available literature.

Kaynakça

  • 1. Pennington CR, Powell-Tuck J, Shaffer J. Review article: artificial nutritional support for improved patient care. Aliment Pharmacol Ther 1995;9: 471-81.
  • 2. Gauderer MWL, Ponsky JL, Izant RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Paediatr Surg 1980;15: 872–75
  • 3. Kumar S, Langmore S, Goddeau RP, et al. Predictors of percutaneous endoscopic gastrostomy tube placement in patients with severe dysphagia from an acute subacute hemispheric infarction. J.Stroke Cerebrovasc Dis 2010;19:1-7.
  • 4. Ermis F, Ozel M, Oncu K, et al. Indications, complications andl ongterm follow-up of patients under going percutaneous endoscopic gastrostomy: A retrospective study. Wien Klin Wochenschr 2012;124:148- 53.
  • 5. Beaver ME, Myers JN, Griffenberg L, Waugh K. Percutaneous fluoroscopic gastrostomy tubeplacement in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 1998;124:1141-4
  • 6. Jones M, Santanello SA, Falcone RE. Percutaneous endoscopic vs surgical gastrostomy. JPEN J Parenter Enteral Nutr. 1990;14: 533–34
  • 7. Grant JP. Percutaneous endoscopic gastrostomy initial placement by single endoscopic technique and long-termfollow-up. Ann Surg 1993; 217: 168-74.
  • 8. Virnig DJ, Frech EJ, Delegge MH, Fang JC. Direct percutaneous endoscopic jejunostomy: a case series in pediatric patients. Gastrointest Endosc 2008;67:984-7.
  • 9. Maple J, Petersen B, Baron TH, et al. Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts. Am J Gastroenterol 2005;100:2681-8.
  • 10. Harbrecht BG, Moraca RJ, Saul M, Courcoulas AP. Percutaneus endoscopic gastrostomy reduces total hospital costs in head-injured patients. Am J Surg 1998;176:311-4.
  • 11. Dwyer KM, Thurber JS, Benoit RS, Fakhry SM. Percutaneous endoscopic gastrostomy: the preferred method of elective feding tubeplacement in trauma patients. J Trauma 2002;52:26-32
  • 12. Goldberg LS, Altman KW. The role of gastrostomy tubeplacement in advanced dementia with dysphagia: a critical review. Clin Interv Aging 2014;9:1733-9.
  • 13. Özgüç H, Gökçe E, Altınel Y, Kırdakalil T. Bir genel cerrahi kliniğinin perkütan endoskopik gastrostomi deneyimi. Turkish Journal of Surgery/Ulusal Cerrahi Dergisi 2011;27.3.
  • 14. Temiz A, Aslan OB, Albayrak Y, Albayrak F, Kısaoğlu A, Er S. Perkütan endoskopik gastrostomi: endikasyon ve komplikasyonlar. Akademik Gastroenteroloji Dergisi 2015; 113-16.
  • 15. Etik DÖ, Suna N, Öcal S, Selçuk H. Percutaneous endoscopic gastrostomy in older patient population. Endoskopi Gastrointestinal 2018; 26(1): 06-11
  • 16. Coşkun O, Arı D. Perkütan endoskopik gastrostomi uygulamasındaki sonuçlarımız: 58 olgunun değerlendirilmesi. Endoskopi Gastrointestinal 1019; 27(3): 93-96.
  • 17. Lee SP, Lee KN, Lee OY, et al. Risk factors for complications of percutaneous endoscopic gastrostomy. Dig Dis Sci 2014;59:117-25
  • 18. Şenol Z, Karakaş DÖ, Yılmaz İ, et al. Perkütan endoskopik gastrostomi tecrübemiz: 64 olgunun değerlendirilmesi. Van Tıp Dergisi 2013;20:52- 6.
  • 19. Vanis N, Saray A, Gornjakovic S, Mesihovic R. Percutaneous endoscopic gastrostomy (PEG): retrospective analysis of a 7-year clinical experience. Acta Inform Med 2012; 20: 235-37
  • 20. Preclik G, Grüne S, Leser HG, et al. Prospective, randomised, double blind trial of prophylaxis with single dose of coamoxiclav before percutaneous endoscopic gastrostomy. BMJ 1999; 319: 881-84
  • 21. Huc T, Spicak J. Complications of percutaneous endoscopic gastrostomy. Best Practice & Research Clinical Gastroenterology. 2016;30(5);769-81
  • 22. Rosenberger LH, Newhook T, Schirmer B, Sawyer RG. Late accidental dislodgement of a percutaneous endoscopic gastrostomy tube: an underestimated burden on patients and the health care system. SurgEndosc 2011; 25: 3307-11
  • 23. Blomberg J, Lagergren J, Martin L, Mattsson F, Lagergren P. Complication safter percutaneous endoscopic gastrostomy in a prospective study. Scandinavian Journal of Gastroenterology. 2012; 47: 737–42
  • 24. Gençosmanoğlu R, Şad O, Özdoğan O, et al. Perkütan Endoskopik Gastrostomi: 50 olguluk seri sonuçları. 17. Ulusal Gastroenteroloji Haftası, Antalya 2000; Poster bildiri. Turk J Gstroenterol 2000;11(Suppl 1):36-P103.
  • 25. Erdil A, Tüzün A, Saka M, et al. Perkütan endoskopik gastrostomi uygulamalarımız ve sonuçları. Gülhane Tıp Dergisi 2001;43:379-83.

İKİNCİ BASAMAK DEVLET HASTANEMİZDE PERKÜTAN ENDOSKOPİK GASTROSTOMİ UYGULAMA SONUÇLARIMIZ

Yıl 2023, Cilt: 4 Sayı: 1, 6 - 10, 29.03.2023
https://doi.org/10.48176/esmj.2023.96

Öz

Giriş: Bu çalışmanın amacı; 2. basamak Burdur Devlet Hastanemizde 3 yıllık sürede uygulanan Perkütan Endoskopik Gastrostomi (PEG) hastalarında, endikasyonları, hastanın yattığı birim, PEG ile yaşam sürelerinin belirlenmesi ve komplikasyonlarının tanımlanmasıdır.
Yöntemler: Bu çalışmada Ocak 2019- Ocak 2022 tarihleri arasında hastanemiz endoskopi ünitesinde PEG uygulanan hastalar retrospektif olarak değerlendirildi. PEG takılan hastaların yaş, cinsiyet,
hastanın yattığı klinik, PEG takılma endikasyonu, PEG sonrası gelişen komplikasyon ve hastanın sağkalımı olgu rapor formuna yazıldı. Koagülasyon bozukluğu, hemodinamik instabilite, peritonit,
sepsis, giriş alanında enfeksiyon varlığı, peritonitis karsinomatoza, total gastrektomi hikayesi ve gastrik varisleri bulunanlara PEG uygulanmamıştır.
Bulgular: Çalışmaya dahil edilen toplam 120 hastanın yaş ortancası 79 (17-100) yıldı ve 66(%55)’sı erkekti. PEG takılan hastaların 14 (%11,7)’ünde komplikasyon görüldü. Görülen komplikasyonların
tamamı minör komplikasyon olup 7(%5,8)’sinde PEG yeri enfeksiyonu, 3(%2,5)’ünde PEG yerinden sızıntı, 3(%2,5)’ünde PEG tıkanması, 1 (% 0,9)’inde PEG çıkması olarak saptandı. Hastaların 73(%60.8)’ünün en az 30 gün hayatta kaldığı tespit edildi. Hastaların en sık % 52,7 ile nöroloji tarafından yönlendirildiği saptandı. En sık PEG takma endikasyonları serebrovasküler hastalık (%56,7 ) ve demans (%29,2) idi.
Sonuç: PEG ile beslenmenin sürdürülmesi ile mukozal bütünlük korunmakta, mukozal bariyer fonksiyonu, intestinal immün yanıt ve normal flora yapısının devamı sağlanmaktadır. Aspirasyon riskinin daha az olması nedeniyle diğer enteral beslenme yollarına göre üstünlüğü kabul edilmiştir. Sonuç olarak ikinci basamak bir devlet hastanesinde PEG ile ilgili deneyimlerinin aktarıldığı bu çalışmada komplikasyon oranlarının, endikasyonların ve yönlendiren kliniklerin literatür verileriyle uyumlu olduğu gösterilmiştir.

Kaynakça

  • 1. Pennington CR, Powell-Tuck J, Shaffer J. Review article: artificial nutritional support for improved patient care. Aliment Pharmacol Ther 1995;9: 471-81.
  • 2. Gauderer MWL, Ponsky JL, Izant RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Paediatr Surg 1980;15: 872–75
  • 3. Kumar S, Langmore S, Goddeau RP, et al. Predictors of percutaneous endoscopic gastrostomy tube placement in patients with severe dysphagia from an acute subacute hemispheric infarction. J.Stroke Cerebrovasc Dis 2010;19:1-7.
  • 4. Ermis F, Ozel M, Oncu K, et al. Indications, complications andl ongterm follow-up of patients under going percutaneous endoscopic gastrostomy: A retrospective study. Wien Klin Wochenschr 2012;124:148- 53.
  • 5. Beaver ME, Myers JN, Griffenberg L, Waugh K. Percutaneous fluoroscopic gastrostomy tubeplacement in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 1998;124:1141-4
  • 6. Jones M, Santanello SA, Falcone RE. Percutaneous endoscopic vs surgical gastrostomy. JPEN J Parenter Enteral Nutr. 1990;14: 533–34
  • 7. Grant JP. Percutaneous endoscopic gastrostomy initial placement by single endoscopic technique and long-termfollow-up. Ann Surg 1993; 217: 168-74.
  • 8. Virnig DJ, Frech EJ, Delegge MH, Fang JC. Direct percutaneous endoscopic jejunostomy: a case series in pediatric patients. Gastrointest Endosc 2008;67:984-7.
  • 9. Maple J, Petersen B, Baron TH, et al. Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts. Am J Gastroenterol 2005;100:2681-8.
  • 10. Harbrecht BG, Moraca RJ, Saul M, Courcoulas AP. Percutaneus endoscopic gastrostomy reduces total hospital costs in head-injured patients. Am J Surg 1998;176:311-4.
  • 11. Dwyer KM, Thurber JS, Benoit RS, Fakhry SM. Percutaneous endoscopic gastrostomy: the preferred method of elective feding tubeplacement in trauma patients. J Trauma 2002;52:26-32
  • 12. Goldberg LS, Altman KW. The role of gastrostomy tubeplacement in advanced dementia with dysphagia: a critical review. Clin Interv Aging 2014;9:1733-9.
  • 13. Özgüç H, Gökçe E, Altınel Y, Kırdakalil T. Bir genel cerrahi kliniğinin perkütan endoskopik gastrostomi deneyimi. Turkish Journal of Surgery/Ulusal Cerrahi Dergisi 2011;27.3.
  • 14. Temiz A, Aslan OB, Albayrak Y, Albayrak F, Kısaoğlu A, Er S. Perkütan endoskopik gastrostomi: endikasyon ve komplikasyonlar. Akademik Gastroenteroloji Dergisi 2015; 113-16.
  • 15. Etik DÖ, Suna N, Öcal S, Selçuk H. Percutaneous endoscopic gastrostomy in older patient population. Endoskopi Gastrointestinal 2018; 26(1): 06-11
  • 16. Coşkun O, Arı D. Perkütan endoskopik gastrostomi uygulamasındaki sonuçlarımız: 58 olgunun değerlendirilmesi. Endoskopi Gastrointestinal 1019; 27(3): 93-96.
  • 17. Lee SP, Lee KN, Lee OY, et al. Risk factors for complications of percutaneous endoscopic gastrostomy. Dig Dis Sci 2014;59:117-25
  • 18. Şenol Z, Karakaş DÖ, Yılmaz İ, et al. Perkütan endoskopik gastrostomi tecrübemiz: 64 olgunun değerlendirilmesi. Van Tıp Dergisi 2013;20:52- 6.
  • 19. Vanis N, Saray A, Gornjakovic S, Mesihovic R. Percutaneous endoscopic gastrostomy (PEG): retrospective analysis of a 7-year clinical experience. Acta Inform Med 2012; 20: 235-37
  • 20. Preclik G, Grüne S, Leser HG, et al. Prospective, randomised, double blind trial of prophylaxis with single dose of coamoxiclav before percutaneous endoscopic gastrostomy. BMJ 1999; 319: 881-84
  • 21. Huc T, Spicak J. Complications of percutaneous endoscopic gastrostomy. Best Practice & Research Clinical Gastroenterology. 2016;30(5);769-81
  • 22. Rosenberger LH, Newhook T, Schirmer B, Sawyer RG. Late accidental dislodgement of a percutaneous endoscopic gastrostomy tube: an underestimated burden on patients and the health care system. SurgEndosc 2011; 25: 3307-11
  • 23. Blomberg J, Lagergren J, Martin L, Mattsson F, Lagergren P. Complication safter percutaneous endoscopic gastrostomy in a prospective study. Scandinavian Journal of Gastroenterology. 2012; 47: 737–42
  • 24. Gençosmanoğlu R, Şad O, Özdoğan O, et al. Perkütan Endoskopik Gastrostomi: 50 olguluk seri sonuçları. 17. Ulusal Gastroenteroloji Haftası, Antalya 2000; Poster bildiri. Turk J Gstroenterol 2000;11(Suppl 1):36-P103.
  • 25. Erdil A, Tüzün A, Saka M, et al. Perkütan endoskopik gastrostomi uygulamalarımız ve sonuçları. Gülhane Tıp Dergisi 2001;43:379-83.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri, Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Kemal Yetiş Gülsoy 0000-0002-3496-7004

Ferit Çelik 0000-0003-4459-7657

Semiha Orhan 0000-0003-2617-6197

Yayımlanma Tarihi 29 Mart 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 1

Kaynak Göster

APA Gülsoy, K. Y., Çelik, F., & Orhan, S. (2023). PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL. Eskisehir Medical Journal, 4(1), 6-10. https://doi.org/10.48176/esmj.2023.96
AMA Gülsoy KY, Çelik F, Orhan S. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL. Eskisehir Med J. Mart 2023;4(1):6-10. doi:10.48176/esmj.2023.96
Chicago Gülsoy, Kemal Yetiş, Ferit Çelik, ve Semiha Orhan. “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL”. Eskisehir Medical Journal 4, sy. 1 (Mart 2023): 6-10. https://doi.org/10.48176/esmj.2023.96.
EndNote Gülsoy KY, Çelik F, Orhan S (01 Mart 2023) PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL. Eskisehir Medical Journal 4 1 6–10.
IEEE K. Y. Gülsoy, F. Çelik, ve S. Orhan, “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL”, Eskisehir Med J, c. 4, sy. 1, ss. 6–10, 2023, doi: 10.48176/esmj.2023.96.
ISNAD Gülsoy, Kemal Yetiş vd. “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL”. Eskisehir Medical Journal 4/1 (Mart 2023), 6-10. https://doi.org/10.48176/esmj.2023.96.
JAMA Gülsoy KY, Çelik F, Orhan S. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL. Eskisehir Med J. 2023;4:6–10.
MLA Gülsoy, Kemal Yetiş vd. “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL”. Eskisehir Medical Journal, c. 4, sy. 1, 2023, ss. 6-10, doi:10.48176/esmj.2023.96.
Vancouver Gülsoy KY, Çelik F, Orhan S. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL. Eskisehir Med J. 2023;4(1):6-10.