Perkutan gastrostomi kateterleri: Büyük olanlar incelere oranla daha mi iyi?

Percutaneous fluoroscopic gastrostomy catheter placement: Is larger better than small bore?

Abstract

Aim: To compare the dysfunction and complication rates of small bore and large bore gastrostomy catheters. Material and Methods: A total of 521 patients (291 males, 230 females, mean age 56 years, range 16-90 years) underwent percutaneous fluoroscopic gastrostomy placement between August 2000 and January 2009. Choice of catheter was based on the preference of the Radiologist. Data was collected retrospectively with institutional review board approval. Radiology reports provided clinical history, indication for gastrostomy, information of the catheter, technical success, and immediate outcome. Post procedural complications and clinical outcomes were obtained. Results: All catheters were placed successfully. 15 patients with anatomic difficulties for G tube placement were discarded from the study. Patients who received large bore and small bore catheters were compared. Patients with larger catheters (18F) had fewer short and long term complications and tube dysfunction compared to patients with smaller bore catheters (14F). Discussion and Conclusions: Patients who received small bore gastrostomy catheters were significantly more prone to tube dysfunction. Large bore catheters should be preferred for fewer complications in short and long term.

Özet

Amaç: Ince ve kalin gastrostomi kateterlerinin disfonksiyon ve komplikasyon oranlarini mukayese etmek amaçlandı. Yöntem: 521 hastaya Agustos 2000 ile Ocak 2009 arasinda (291 erkek, 230 kadin, ortalama yas 56, yas araligi 16-90) perkutan gastrostomi kateteri yerlestirildi. Klinik bilgi, gastrostomi endikasyonu, kateter secimi, teknik basari ve takipler degerlendirildi. Post prosedur komplikasyonlar ve klinik sonuclar elde edildi. Sonuç: Kateterler basari ile yerlestirildi. 15 hasta anatomik zorluk nedeniyle calismadan cikartildi. Kalin ve ince gastrostomi kateterleri mukayese edildi. Kalin kateterler (18F) ince olanlara (14F) oranla daha az kisa ve uzun donem komplikasyon ve tup disfonksiyonuna maruz kaldi. Tartışma: Ince gastrostomi kateterleri tup disfonksiyonuna daha egilimli bulundu. Kalin kateterler erken ve uzun donemdeki daha az komplikasyon oranlarindan oturu tercih edilmelidirler.