Haydarpasa Numune Med J. 2020; 60(1): 71-75 | DOI: 10.14744/hnhj.2020.35902

Comparison of Single-incision Surgical Gastrostomy with other Gastrostomy Methods

Zeliha Akýþ Yýldýz, Mehmet Arpacýk, Ceyhan Þahin, Hayriye Nihan Ayyýldýz, Aytekin Kaymakçý
Department of Pediatric Surgery, University of Health Science, Umraniye Training and Research Hospital, Istanbul, Turkey

INTRODUCTION: Many surgical methods have been defined for gastrostomy, including open surgery and endoscopic methods. There are very few reports on single-incision gastrostomy. In this study, we aimed to share our experience of single-incision surgical gastrostomy, which is less known than other methods, by comparing it with other gastrostomy methods.

METHODS: Between June 2016 and June 2019, in Ümraniye E.A.H. 15, patients undergoing SIG, 14 patients undergoing Stamm gastrostomy (SG) and 11 patients undergoing percutaneous endoscopic gastrostomy (PEG) were evaluated retrospectively in this study. Age, sex, indication for operation, operation method, operation time and postoperative complications were compared.

RESULTS: Gastric perforation was observed in one patient, and a gastrostomy tube was absent in another patient. Laparotomy and SG were performed in both patients. Two patients who underwent SIG had eventration at the incision site and granulation around the tube in six patients. Evolution was treated with local suture and granulation was treated with silver nitrate. In one patient who underwent Stamm gastrostomy, laparotomy was performed because of the development of brid ileus. No major complication requiring laparotomy was seen in any patient who underwent SIG.

DISCUSSION AND CONCLUSION: SIG is easy to perform, minimally invasive, and the complication rate is lower than other methods.

Keywords: Child, gastrostomy; single-incision gastrostomy.

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Tek insizyon cerrahi gastrostominin diðer gastrostomi yöntemleri ile karþýlaþtýrýlmasý

Zeliha Akýþ Yýldýz, Mehmet Arpacýk, Ceyhan Þahin, Hayriye Nihan Ayyýldýz, Aytekin Kaymakçý
Ümraniye Eðitim ve Araþtýrma Hastanesi, Saðlýk Bilimleri Üniversitesi, Çocuk Cerrahisi Kliniði, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Gastrostomi için günümüzde açýk cerrahi ve endoskopik yöntemler olmak üzere birçok cerrahi yöntem tanýmlanmýþtýr. Tek insizyon gastrostomi (TÝG) ile ilgili ise oldukça az sayýda yayýn mevcuttur. Diðer yöntemlere göre daha az bilinen tek insizyon cerrahi gastrostomi deneyimimizi diðer gastrostomi yöntemleri ile karþýlaþtýrarak paylaþmayý amaçladýk.
YÖNTEM ve GEREÇLER: Haziran 2016 ile Haziran 2019 tarihleri arasýnda Ümraniye E.A.H. de TÝG yapýlan 15 olgu, Stamm gastrostomi (SG) yapýlan 14 olgu ve perkütan endoskopik gastrostomi (PEG) yapýlan 11 olgu retrospektif olarak deðerlendirildi. Olgularýn yaþ, cinsiyet, ameliyat endikasyonu, ameliyat yöntemi, ameliyat süresi, postoperatif komplikasyonlar karþýlaþtýrýldý.
BULGULAR: PEG yapýlan olgulardan birinde mide perforasyonu ve diðerinde gastrostomi tüpünün yerinde olmadýðý izlendi. Her iki hastayada laparotomi ve SG yapýldý. TÝG yapýlan 2 olguda insizyon yerinde evantrasyon ve altý hastada tüp çevresinde granülasyon izlendi. Evantrasyon lokal sütürle tedavi edilirken granülasyon gümüþ nitrat ile tedavi edildi. Stam gastrostomi yapýlan 1 olguda brid ileus geliþmesi nedeniyle laparotomi yapýldý. TÝG yapýlan hiçbir olguda laparatomi gerektirecek majör komplikasyon görülmedi.
TARTIÞMA ve SONUÇ: TÝG kolay uygulanabilir, minimal invaziv ve komplikasyon oraný da diðer yöntemlere göre düþüktür.

Anahtar Kelimeler: Gastrostomi, tek insizyon gastrostomi, çocuk.

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