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LETTER TO THE EDITOR PERCUTANEOUS GASTROSTOMY

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Acta Medica Mediterranea, 2014, 30: 1175
LETTER TO THE EDITOR
PERCUTANEOUS GASTROSTOMY PERFORMED WITH A MAGNETIC TIPPED NASOGASTRIC
TUBE
Ibrahim UYGUN, MD, Associate Professor
Department of Pediatric Surgery and Pediatric Urology, Dicle University Medical Faculty, 21280 Diyarbakir, Turkey
Dear Sir,
Magnets have been used increasingly to treat various diseases such as biliary duct strictures, malignant
gastrointestinal obstruction, pectus excavatum, and esophageal atresia(1-5). We congratulate Akkaya et al.,
who described the performance of percutaneous gastrostomy in the rat using a reconfigured magnetic tipped
nasogastric tube as a new method involving minimal incisions(1). Magnetic compression ostomies (gastrostomy, colostomy, and cystostomy) were first described in our studies(2-4). Gastrostomy requires general or
local anesthesia, special equipment, and X-ray exposure when using the fluoroscopic technique. It is also
associated with major and minor complications and high mortality rates(2). In our and Akkaya et al.’s small
studies, the magnetic gastrostomy technique did not require expensive equipment, and no complications
were observed in any of the rats(1,2).
The magnetic insertion catheter was first specially designed by us. Its use involves the insertion of two
small cylindrical magnets (outer diameter, 2 mm; thickness, 1 mm) into an 8-F truncated feeding tube(2,3).
Although Akkaya et al. reconfigured this catheter with a 6-F nasogastric tube by attaching a longer magnet
(2 × 5 mm) to the tip, they did not mention from where the reconfiguration was performed. Their magnetic
tube size must have been 8-F, not 6-F, as shown by the blue nasogastric tube in Figure 1a and the mismatching of the outer diameter of the attached magnet with the tube size. They specified that an 8-F Foley
catheter was inserted for the gastrostomy. The rats were fed an enteral feeding solution via the gastrostomy
for 2 days. However, we think that an 8-F Foley balloon catheter is too large for a gastrostomy in a rat and
that monitoring complications for only 2 days is not enough time to allow for wound healing. We wonder
how the authors maintained the Foley catheter and fed the rats via the catheter. Akkaya et al.’s article is
almost identical to our magnetic gastrostomy study(2). However, we congratulate them for addressing
magnetic ostomy techniques.
Magnetic gastrostomy techniques are easy to perform in rats and may be a simple alternative to some
gastrostomy techniques used in humans. Conversely, further studies are required to develop magnetic
ostomy techniques in large animals and humans.
Received September 04, 2014; Accepted September 20, 2014
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References
Akkaya A, Sit M, Demirhan A, Bilgi M, Tekelioglu UY, Kocoglu H, Tekce H. Percutaneous gastrostomy performed with
magnetic tipped nasogastric tube: a new method. Acta Medica Mediterranea 2014; 30: 319-22.
Uygun I, Okur MH, Cimen H, Keles A, Yalcin O, Ozturk H, Otcu S. Magnetic compression gastrostomy in the rat. Pediatr
Surg Int 2012; 28: 529-32.
Uygun I, Okur MH, Arayici Y, Keles A, Ozturk H, Otcu S. Magnetic compression ostomy for simple tube colostomy in rats-magnacolostomy. Adv Clin Exp Med 2012; 21: 301-5.
Uygun I, Okur MH, Cimen H, Keles A, Yalcin O, Ozturk H, Otcu S. Magnetic compression ostomy as new cystostomy technique in the rat: magnacystostomy. Urology 2012; 79: 738-42.
Harrison MR: What if? Why not? J Pediatr Surg 2010; 45: 1-10.
Ibrahim UYGUN, MD, Associate Professor
Department of Pediatric Surgery and Pediatric Urology, Dicle University Medical Faculty
21280 Diyarbakir
(Turkey)
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