Öz
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.
Anahtar Kelimeler
Enteral feeding Percutaneous endoscopic gastrostomy Early complications Late complications
Kaynakça
- 1. Kahveci G, Akin S. Knowledge levels and practices about the enteral nutritional practices of ınformal caregivers caring for patients fed through a percutaneous endoscopic gastrostomy tube: a descriptive observational study. Gastroenterol Nurs. 2021;01:44(5):80-90. doi: 10.1097/SGA.0000000000000623
- 2. Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980;15:872-5. doi:10.1016/S0022- 3468(80)80296-X
- 3. Wanden-Berghe C, Patino-Alonso MC, Galindo-Villardón P, Sanz-Valero J. Complications associated with enteral nutrition: CAFANE study. Nutrients. 2019;11(9):2041. doi:10.3390/nu11092041.
- 4. Rahnemai-Azar AR, Rahnemai-Azar AA, Naghshizadian R, Kurtz A., Farkas DT. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management. World J Gastroenterol. 2014;20(24):7739- 7751. doi:10.3748/wjg.v20.i24.7739
- 5. Gomes CA Jr, Andriolo RB, Bennett C, Lustosa SA, Matos D, Waisberg DR, Waisberg J. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane database of systematic reviews. 2015;5. doi:10.1002/14651858. CD008096.pub4
- 6. Sobotka L. (2017). Clinical nutrition basics. In Gundogdu RH. (Ed.), Nutritional Support Techniques. (4th ed., pp. 309-415). Ankara, Turkey: Byt Publication.
- 7. Stenberg K, Eriksson A, Odensten C, Darehed D. Mortality and complications after percutaneous endoscopic gastrostomy: a retrospective multicentre study. BMC Gastroenterol. 2022;22,361. doi:10.1186/s12876-022- 02429-0
- 8. Hucl T, Spicak J. Complications of percutaneous endoscopic gastrostomy. Best Pract Res Clin Gastroenterol. 2016;30(5):769-781. doi:10.1016/j.bpg.2016.10.002
- 9. Coşkun O. Our results in percutaneous endoscopic gastrostomy: Evaluation of 58 cases. Endoscopy Gastrointestinal. 2019;27(3):93-96. doi:10.17940/endoskopi. 661561
- 10. Çelik, Y, Erbil, OA, Çinçin, TG., Yıldız, S, Özkan, Y, Demircan, F. Percutaneous endoscopic gastrostomy applications for enteral nutrition. Bozok Medical Journal. 2019;9(4):69- 72. doi: 10.16919/bozoktip.535030
- 11. Anderloni A, Di Leo M, Barzaghi F, Semeraro R, Meucci G, Marino R, et al. Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study. Dig Liver Dis. 2019 Oct;51(10):1380-1387. doi: 10.1016/j. dld.2019.03.024.
- 12. Yilmaz G, Tanrikulu Y, Goksoy B. An Analysis of Percutaneous Endoscopic Gastrostomy Complications. J Coll Physicians Surg Pak. 2022 Aug;32(8):1051-1055. doi: 10.29271/jcpsp.2022.08.1051
- 13. Pineda-Cortés D, Paz-Rodríguez F, Trujillo-de Los Santos Z, Sánchez-Guzmán MA, Nava-Galán MG, Santana-Aguilar E, et al. Exploratory study on gastrostomy in patients with neurological diseases: Usefulness and impact. Neurologia. 2019;37(6):428-433. doi:10.1016/j.nrl.2019.04.003
- 14. Pih GY, Na HK, Ahn JY, Jung KW, Kim DH, Lee JH, et al. Risk factors for complications and mortality of percutaneous endoscopic gastrostomy insertion. BMC Gastroenterol. 2018;28;18(1):101.doi:10.1186/s12876-018-0825-8
- 15. Alsaeed D, Furniss D, Blandford A, Smith F, Orlu M. Carers’ experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies. Journal of Clinical Pharmacy and Therapeutics. 2018;43(3).359-365. doi:10.1111/jcpt.12664
- 16. Roveron G, Antonini M, Barbierato M, Calandrino V, Canese G, Chiurazzi LF, et al. Clinical practice guidelines for the nursing management of percutaneous endoscopic gastrostomy and jejunostomy (PEG/PEJ) in adult patients. Journal of Wound, Ostomy and Continence Nursing. 2018;45(4):326-334.doi:10.1097/ WON.0000000000000442
- 17. Blumenstein I, Shastri YG, Stein J. Gastroenteric tube feeding: Techniques, problems and solutions, World J Gastroenterol. 2014; 20(26): 8505-8524. doi:10.3748/ wjg.v20.i26.8505
- 18. Tarig N, Ali A, Chen C. Endoscopic Enteral Access. Surg Clin N Am. 2020;100(6):1091-1113.doi:10.1016/j. suc.2020.08.009
- 19. Bischoff SC, Austin P, Boeykens K, Chourdakis M, Cuerda C, Jonkers-Schuitema C, et al. ESPEN guideline on home enteral nutrition. Clin Nutr. 2020;39(1): 5-22. doi:10.1016/j.clnu.2019.04.022
- 20. Boland K, Maher N, O’Hanlon C, O’Sullivan M, Rice N, Smyth M, et al. Home enteral nutrition recipients: Patient perspectives on training, complications, and satisfaction. Frontline Gastroenterology. 2017;8 (1):79-84. doi:10.1136/flgastro-2016-100736
- 21. Limpias Kamiya KJL, Hosoe N, Takabayashi K, Hayashi Y, Fukuhara S, Mutaguchi M, et al. Factors predicting major complications, mortality and recovery in percutaneous endoscopic gastrostomy. JGH Open. 2021;5:590-598. doi:10.1002/jgh3.12538
- 22. Demirci H, Kilciler G, Öztürk K, Kantarcioğlu M, Uygun A, Bağci S, et al. Our experience in percutaneous endoscop ic gastrostomy applications. Endoscopy Gastrointestinal. 2015;23(3):73-76. doi:10.17940/endoskopi.468528
- 23. Alivizatos V, Gavala V, Alexopoulos P, Apostolopoulos A, Bajrucevic S. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition. Indian Journal of Palliative Care. 2012;18(1): 31-3. doi:10.4103/0973-1075.97346
- 24. Malhi H, Thompson R. PEG tubes: Dealing with complications. Nursing Times. 2014;110(45):18-21.
- 25. Kartal M, Kalaycı T, Yeni M. Percutaneous Endoscopic Gastrostomy Experience of a Tertiary Health Center. Çukurova Journal of Anesthesia and Surgical Sciences. 2022:5(1):54-60. doi: 10.36516/jocass.2022.97.
Öz
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.
Anahtar Kelimeler
Enteral beslenme Perkütan endoskopik gastrostomi Erken komplikasyonlar Geç komplikasyonlar
Kaynakça
- 1. Kahveci G, Akin S. Knowledge levels and practices about the enteral nutritional practices of ınformal caregivers caring for patients fed through a percutaneous endoscopic gastrostomy tube: a descriptive observational study. Gastroenterol Nurs. 2021;01:44(5):80-90. doi: 10.1097/SGA.0000000000000623
- 2. Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980;15:872-5. doi:10.1016/S0022- 3468(80)80296-X
- 3. Wanden-Berghe C, Patino-Alonso MC, Galindo-Villardón P, Sanz-Valero J. Complications associated with enteral nutrition: CAFANE study. Nutrients. 2019;11(9):2041. doi:10.3390/nu11092041.
- 4. Rahnemai-Azar AR, Rahnemai-Azar AA, Naghshizadian R, Kurtz A., Farkas DT. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management. World J Gastroenterol. 2014;20(24):7739- 7751. doi:10.3748/wjg.v20.i24.7739
- 5. Gomes CA Jr, Andriolo RB, Bennett C, Lustosa SA, Matos D, Waisberg DR, Waisberg J. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane database of systematic reviews. 2015;5. doi:10.1002/14651858. CD008096.pub4
- 6. Sobotka L. (2017). Clinical nutrition basics. In Gundogdu RH. (Ed.), Nutritional Support Techniques. (4th ed., pp. 309-415). Ankara, Turkey: Byt Publication.
- 7. Stenberg K, Eriksson A, Odensten C, Darehed D. Mortality and complications after percutaneous endoscopic gastrostomy: a retrospective multicentre study. BMC Gastroenterol. 2022;22,361. doi:10.1186/s12876-022- 02429-0
- 8. Hucl T, Spicak J. Complications of percutaneous endoscopic gastrostomy. Best Pract Res Clin Gastroenterol. 2016;30(5):769-781. doi:10.1016/j.bpg.2016.10.002
- 9. Coşkun O. Our results in percutaneous endoscopic gastrostomy: Evaluation of 58 cases. Endoscopy Gastrointestinal. 2019;27(3):93-96. doi:10.17940/endoskopi. 661561
- 10. Çelik, Y, Erbil, OA, Çinçin, TG., Yıldız, S, Özkan, Y, Demircan, F. Percutaneous endoscopic gastrostomy applications for enteral nutrition. Bozok Medical Journal. 2019;9(4):69- 72. doi: 10.16919/bozoktip.535030
- 11. Anderloni A, Di Leo M, Barzaghi F, Semeraro R, Meucci G, Marino R, et al. Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study. Dig Liver Dis. 2019 Oct;51(10):1380-1387. doi: 10.1016/j. dld.2019.03.024.
- 12. Yilmaz G, Tanrikulu Y, Goksoy B. An Analysis of Percutaneous Endoscopic Gastrostomy Complications. J Coll Physicians Surg Pak. 2022 Aug;32(8):1051-1055. doi: 10.29271/jcpsp.2022.08.1051
- 13. Pineda-Cortés D, Paz-Rodríguez F, Trujillo-de Los Santos Z, Sánchez-Guzmán MA, Nava-Galán MG, Santana-Aguilar E, et al. Exploratory study on gastrostomy in patients with neurological diseases: Usefulness and impact. Neurologia. 2019;37(6):428-433. doi:10.1016/j.nrl.2019.04.003
- 14. Pih GY, Na HK, Ahn JY, Jung KW, Kim DH, Lee JH, et al. Risk factors for complications and mortality of percutaneous endoscopic gastrostomy insertion. BMC Gastroenterol. 2018;28;18(1):101.doi:10.1186/s12876-018-0825-8
- 15. Alsaeed D, Furniss D, Blandford A, Smith F, Orlu M. Carers’ experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies. Journal of Clinical Pharmacy and Therapeutics. 2018;43(3).359-365. doi:10.1111/jcpt.12664
- 16. Roveron G, Antonini M, Barbierato M, Calandrino V, Canese G, Chiurazzi LF, et al. Clinical practice guidelines for the nursing management of percutaneous endoscopic gastrostomy and jejunostomy (PEG/PEJ) in adult patients. Journal of Wound, Ostomy and Continence Nursing. 2018;45(4):326-334.doi:10.1097/ WON.0000000000000442
- 17. Blumenstein I, Shastri YG, Stein J. Gastroenteric tube feeding: Techniques, problems and solutions, World J Gastroenterol. 2014; 20(26): 8505-8524. doi:10.3748/ wjg.v20.i26.8505
- 18. Tarig N, Ali A, Chen C. Endoscopic Enteral Access. Surg Clin N Am. 2020;100(6):1091-1113.doi:10.1016/j. suc.2020.08.009
- 19. Bischoff SC, Austin P, Boeykens K, Chourdakis M, Cuerda C, Jonkers-Schuitema C, et al. ESPEN guideline on home enteral nutrition. Clin Nutr. 2020;39(1): 5-22. doi:10.1016/j.clnu.2019.04.022
- 20. Boland K, Maher N, O’Hanlon C, O’Sullivan M, Rice N, Smyth M, et al. Home enteral nutrition recipients: Patient perspectives on training, complications, and satisfaction. Frontline Gastroenterology. 2017;8 (1):79-84. doi:10.1136/flgastro-2016-100736
- 21. Limpias Kamiya KJL, Hosoe N, Takabayashi K, Hayashi Y, Fukuhara S, Mutaguchi M, et al. Factors predicting major complications, mortality and recovery in percutaneous endoscopic gastrostomy. JGH Open. 2021;5:590-598. doi:10.1002/jgh3.12538
- 22. Demirci H, Kilciler G, Öztürk K, Kantarcioğlu M, Uygun A, Bağci S, et al. Our experience in percutaneous endoscop ic gastrostomy applications. Endoscopy Gastrointestinal. 2015;23(3):73-76. doi:10.17940/endoskopi.468528
- 23. Alivizatos V, Gavala V, Alexopoulos P, Apostolopoulos A, Bajrucevic S. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition. Indian Journal of Palliative Care. 2012;18(1): 31-3. doi:10.4103/0973-1075.97346
- 24. Malhi H, Thompson R. PEG tubes: Dealing with complications. Nursing Times. 2014;110(45):18-21.
- 25. Kartal M, Kalaycı T, Yeni M. Percutaneous Endoscopic Gastrostomy Experience of a Tertiary Health Center. Çukurova Journal of Anesthesia and Surgical Sciences. 2022:5(1):54-60. doi: 10.36516/jocass.2022.97.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Hizmetleri ve Sistemleri (Diğer) |
| Bölüm | Makaleler |
| Yazarlar | |
| Erken Görünüm Tarihi | 21 Mart 2024 |
| Yayımlanma Tarihi | 31 Mart 2024 |
| Gönderilme Tarihi | 11 Kasım 2023 |
| Kabul Tarihi | 12 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 14 Sayı: 1 |
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