Çocuklarda Perkütan Endoskopik Gastrostominin Mide Miyoelektrik Aktivitesine Etkisinin Elektrogastrografi ile Değerlendirilmesi

Abstract

Electrogastrography (EGG) is a non-invasive technique for recording myoelectrical activity of the stomach using cutaneous electrodes placed on the abdominal skin. The aim of the study is to investigate the effect of percutaneous endoscopic gastrostomy (PEG) placement on gastric myoelectric activity. Children who required PEG placement were included in the study. After obtaining informed consent, an EGG before PEG placement was performed and EGG analysis was made using software (Polygram for Windows, version 6.40, Synectics Medical Inc, Stockholm, Sweden). Spectral analysis was conducted and dominant frequency, dominant frequency instability coefficient, percentage of slow waves and dominant power ratio was determined both before and after meal. Frequencies between 2.0 and 4.0 cycle per minute (cpm) were defined as normal gastric slow wave frequency whereas < 2.0 cpm was defined as bradygastria and >4.0 as tachygastria. After PEG placement the EGG recording was repeated given the identical conditions. Seventeen patients (10 girls; 58.8%) were included in the study with a mean age of 4.1 ± 3.2 (0.6 ? 12.9). The indication for PEG insertion was inability to swallow in 15 children (88.2%) with neurologic impairment. Before PEG placement 64.7% of patients had pre-prandial dysrhythmia. There was no statistically significant difference regarding gastric electrical activity measured by means of EGG, neither in pre-prandial or post-prandial states, between before and after PEG placement. Seven minor (41.2%) complications occurred in 5 patients (29.4%) and 1 patient (5.9%) had a major complication. Three patients required fundoplication due to severe gastroesophageal reflux after PEG placement. It was found that the placement of PEG does not improve or worsen gastric myoelectrical activity.