Percutaneous Endoscopic Gastrostomy Experience In A General Surgery Clinic

Aim Percutaneous endoscopic gastrostomy is the most preferable procedure for nutritional support in patients starving for a long time, who have difficulty in swallowing or feeding by oral way due to various diseases. The five years' experience of this surgery clinic was obtained in this study. Material and Method: The indications, complications and long term follow-up were recorded by physicians for 197 patients who had undergone percutaneous endoscopic gastrostomy. We used standart pull method for lite application of gastrostomy. Results: Percutaneous endoscopic gastrostomy was performed successfully in 141 (\% 71) chronic neurological patients, 35 (\% 17) patients with malignancy and 21 (\% 10) patients with various diseases with especially long time ventilation. It was performed on 141 male and 56 female patients, with a median age of 52.7 years (range 14-93 years). One hundred thirdy nine (total mortality 71\%) patients died because of the primary disease and after being discharged from the hospital. There was no mortality attributable to the procedure. The median time the patients used percutaneous endoscopic gastrostomy was 101.4 days (range 1-322 days) excluding 37 (19\%) patients in whom the communication was lost during follow-up. There were a catheter leakage early in 34 and later in 19 patients, unsettled cathether in 6 patients, obstruction in 8 patients and catheter area inflamation in patients. PEG was performed twice in 7 patients. Discussion: Percutaneous endoscopic gastrostomy is a safe and reliable procedure for enteral feeding. The important complications are generally related to catheter care. In order to reduce complicatoins in the long run, further education of caretakers of patients and organization of the nutrition outpatient unit is advisable

Comparison of Limberg flap and excision and primary closure of pilonidal sinus disease, in terms of quality of life and complications

Purpose: The aim of this study was to compare two different treatment methods for pilonidal sinus with respect to complications, recurrence, and patient quality of life. Methods: Five hundred forty-nine patients who underwent surgery for pilonidal sinus between January 2007 and August 2012 were included in thi s study. The patients were classified into group I (excision and primary closure) and group II (Limberg f lap). Results: There was no significant difference in the mean age and gender of t he patients between groups I and II (P = 0.512 and P = 0.472). The duration of surgical operation was lower in group I (P < 0.001). There was no significant difference in hospitalization time after surgery, minor complications, and recurrence between the groups (P = 0.674, P = 1.000, and P = 1.000, respectively). The time required for pain-free walking, urinating, and returning to work was significantly lower in group II (P < 0.001, P < 0.001, and P < 0.001, respectively). The patients in group I stated that they were more satisfied in terms of aesthetics (P < 0.001). Conclusion: According to the results of this study, Limberg flap method has better outcomes compared with excision and primary closure. Therefore, we recommend Limberg f lap for treatment of pilonidal sinus disease. Copyright © 2013, the Korean Surgical Society