Felsher Joshua, Chand Bipan, Ponsky Jeffrey
Minimally Invasive Surgery Center, Department of General Surgery, A80, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, USA.
Am J Surg. 2004 Feb;187(2):254-6. doi: 10.1016/j.amjsurg.2003.11.002.
Percutaneous endoscopic gastrostomy is the standard for long-term enteral access. It can provide enteral nutrition or gastrointestinal decompression. Utilization of the gastrostomy for decompression has traditionally been reported in the setting of malignant obstruction. However, decompressive gastrostomy can play a role in the treatment of nonmalignant bowel dysfunction as well.
Over a 2-year period, 20 of 121 percutaneous endoscopic gastrostomies attempted by this surgical endoscopist were for gastrointestinal decompression.
Eleven of 18 gastrostomies successfully placed for decompression were for benign conditions. In 5 patients with fistulous disease, the purpose of decompression was to divert the gastrointestinal tract until operative repair. Four of these patients have since undergone definitive surgery.
This series presents the successful use of the percutaneous endoscopic gastrostomy for decompression of nonmalignant conditions. In such scenarios, the drainage gastrostomy can be employed as a bridge to future surgery, or as a means of long-term decompression for bowel dysfunction.
经皮内镜下胃造口术是长期肠内通路的标准方法。它可提供肠内营养或胃肠减压。传统上，胃造口术用于减压的情况多见于恶性梗阻。然而，减压性胃造口术在治疗非恶性肠功能障碍中也可发挥作用。
在两年时间里，该外科内镜医师尝试的121例经皮内镜下胃造口术中，有20例用于胃肠减压。
成功放置用于减压的18例胃造口术中，有11例是用于良性疾病。在5例瘘管病患者中，减压的目的是使胃肠道改道直至进行手术修复。其中4例患者后来接受了确定性手术。
本系列报道了经皮内镜下胃造口术成功用于非恶性疾病减压的情况。在这种情况下，引流性胃造口术可作为未来手术的桥梁，或作为肠功能障碍长期减压的一种手段。
