Arnbjörnsson Einar, Backman Torbjörn, Berglund Yvonne, Kullendorff Carl Magnus
Department of Paediatric Surgery, University Hospital, SE-221 85 LUND, Sweden.
Pediatr Surg Int. 2005 Oct;21(10):797-9. doi: 10.1007/s00383-005-1549-8. Epub 2005 Oct 21.
A gastrostomy device is removed from the gastrostoma when no longer needed. The aim of the study was to test the hypothesis of whether it is possible for the surgeon to decide which stoma has to be closed with a gastroraphy and which to leave for a spontaneous closure within a reasonable period of time. Out of a cohort of 321 patients, who had been operated with a video-assisted gastrostomy, we included all the 48 patients having had their gastrostomy button removed. These patients were carefully followed and the closure of the gastrostoma was registered. According to the institutional routine we waited at least 3 months after the removal of the gastrostomy device before suggesting to the child's guardians an operative closure of the stoma. In 26 patients the stoma closed within 3 months, whereas in 22 patients a surgical gastroraphy was performed. We found no differences between the two groups regarding the patients' diagnoses, the duration of the gastrostoma use or patient's age at the time of removal of the gastrostomy device. This study rejected the hypothesis of predictability of the gastrostoma closure. Thus, we recommend a routine expectance after the removal of a gastrostomy device for at least 1 month. If no spontaneous closure occurs, then a gastroraphy should be performed.
当不再需要时，胃造口装置会从胃造口处移除。本研究的目的是检验以下假设：外科医生是否有可能在合理的时间内决定哪些造口需要通过胃缝术关闭，哪些造口可以等待自行关闭。在321例接受电视辅助胃造口术的患者队列中，我们纳入了所有48例已移除胃造口按钮的患者。对这些患者进行了仔细随访，并记录了胃造口的关闭情况。根据机构常规，在移除胃造口装置后，我们至少等待3个月才建议患儿监护人对造口进行手术关闭。26例患者的造口在3个月内关闭，而22例患者进行了外科胃缝术。我们发现两组在患者诊断、胃造口使用时间或移除胃造口装置时的患者年龄方面没有差异。本研究否定了胃造口关闭可预测性的假设。因此，我们建议在移除胃造口装置后常规等待至少1个月。如果没有发生自行关闭，则应进行胃缝术。
