Surgical Gastrostomy in Delayed Emergency: Indications, Morbidity and Mortality in 293 Patients from a Single Center Experience - IMAG Accéder directement au contenu
Article Dans Une Revue International Journal of Surgery Research and Practice Année : 2016

Surgical Gastrostomy in Delayed Emergency: Indications, Morbidity and Mortality in 293 Patients from a Single Center Experience

Résumé

Purpose: Monocentric retrospective 5-years study evaluation of indications and morbi-mortality rates of surgical gastrostomies. Methods: 293 patients under went surgical gastrostomy according to the Witzel technique. Age, gender, indication, type of anesthesia, complications and 30-days mortality were analyzed. Complications were detailed according to type minor (tube site infection, gastric tube removal, obstruction, breakage or leakage, intra-abdominal displacement, parietal hematoma) or major (gastric bleeding, aspiration pneumonia, gastroesophageal reflux, peristomal hernia, peritonitis, digestive perforation, incisional hernia), time of occurrence early (≤ 30 days) or late (> 30 days) and Dindo-Clavien's classification. Results: Mean age was 63-years-old. Gastrostomies were performed for enteral nutrition or gastric decompression in 85% and 15% of cases respectively. The main indications were neurological pathologies (48%), and tumors (oto-rhino-laryngeal tumors (17%), lung tumors (8%), peritoneal carcinomatosis (8%), other digestive cancers (5%), urological cancers (2%), and various abdominal diseases (12%)). Overall mortality at 30-days was 16.3%. Sixty-nine (23.5%) complications occurred, with 13.6% minor and 9.8% major complications. According to Dindo-Clavien's classification, complication were graded respectively in 1-2 (66%), 3(22%) and 4-5 (12%). Patients with the highest mortality rates at 30 days were patients with a complication or procedural failure after endoscopic or radiological gastrostomy (20%), patients with lung tumor (50%), patients with airway pathology (18.9%) and patients with peritoneal carcinomatosis requiring a gastric decompression (16.7%). Conclusion: This single-center experience gives an overview of the results after surgical gastrostomies in delayed emergency. The high morbi-mortality in some groups must challenge the surgical choice versus other endoscopic and radiological procedures, by evaluating the risk to benefit ratio for critically ill patients, taking into account short-term outcome and quality of life.
Fichier principal
Vignette du fichier
international-journal-of-surgery-research-and-practice-ijsrp-3-047.pdf (296.45 Ko) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte
Loading...

Dates et versions

hal-02064521 , version 1 (12-03-2019)

Identifiants

Citer

Anne-Sophie Studer, Vincent Venchiarutti, Edouard Girard, Jessica Morel, Julio Abba, et al.. Surgical Gastrostomy in Delayed Emergency: Indications, Morbidity and Mortality in 293 Patients from a Single Center Experience. International Journal of Surgery Research and Practice, 2016, 3 (2), pp.047. ⟨10.23937/2378-3397/1410047⟩. ⟨hal-02064521⟩
1203 Consultations
53 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More