Pediatric Gastroenterology, Hepatology & Nutrition
- 제7권1호
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- Pages.8-15
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- 2004
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- 2234-8646(pISSN)
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- 2234-8840(eISSN)
소아에서 내시경적 위루술의 합병증
Complications of Percutaneous Endoscopic Gastrostomy (PEG) in Children
- 장수희 (울산대학교 의과대학 서울아산병원 소아과) ;
- 김대연 (울산대학교 의과대학 서울아산병원 소아외과) ;
- 김성철 (울산대학교 의과대학 서울아산병원 소아외과) ;
- 김인구 (울산대학교 의과대학 서울아산병원 소아외과) ;
- 김경모 (울산대학교 의과대학 서울아산병원 소아과)
- Chang, Soo Hee (Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center) ;
- Kim, Dae Yeon (Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
- Kim, Seong Chul (Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
- Kim, In Koo (Department of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
- Kim, Kyung Mo (Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center)
- 투고 : 2004.02.28
- 심사 : 2004.03.19
- 발행 : 2004.03.01
초록
목 적: 내시경적 위루술은 수술적 위루술에 비해 안전하고 합병증 발생이 적은 만성 영양 결핍 환아의 경장 영양법으로 소아에서 이에 대한 비교분석이 드물어 위루술 후 발생하는 합병증에 대해 알아보고자 하였다. 방 법: 1994년부터 2002년까지 위루술을 시행받은 66례의 의무기록정보를 후향적으로 분석하였다. 결 과: 내시경적 위루술 23례(평균연령 49개월, 추적관찰 13개월), 수술적 위루술 43례(평균연령 29개월, 추적관찰 21개월)이었다. 수술군 중 31례는 위저 추벽 성형술과 동시에 위루술을 시행 받았다. 주요 합병증은 수술군의 55%, 내시경군의 33%에서 발생하였다. 주요 합병증 발생은 내시경군(
Purpose: This study was conducted to identify potential dangers involved in procedure and evaluate complications of percutaneous endoscopic gastrostomy (PEG) comparing to surgical gastrostomy (SG). Methods: A retrospective study of 66 children with feeding gastrostomy between 1994 and 2002 was done. Results: Of 66 children, 23 (mean age 29 months) had PEG and 43 (mean age 49 months) had SG. 31 cases of SG group had fundoplication for gastroesophageal reflux disease. PEG groups were followed up with an average 13 months and SG groups with 21 months. Major complications occurred in 33% of PEG group (8/23) and 55% of SG group (24/43). Major complications were significantly lower in PEG group than SG group and minor complications, too (p<0.05). Of major complications, aspiration pneumonia was the most common but paralytic ileus was significantly higher in SG group than PEG group. 8 patients died of underlying disease but not related to gastrostomy. Removals of stomata were done in 5 of PEG group and 3 of SG group. GER recurred in 25% of SG group with fundoplication and newly developed in 17% of SG group. GER persisted in 17% and newly developed in 5% of PEG group. Conclusion: The gastrostomy was a significant procedure with the potential to produce complications. PEG is recommended as an initial procedure in children requiring a feeding gastrostomy but should be considered a major undertaking.