Given M F, Hanson J J, Lee M J
Department of Academic Radiology, Beaumont Hospital, City, Ireland.
Cardiovasc Intervent Radiol. 2005 Nov-Dec;28(6):692-703. doi: 10.1007/s00270-004-7021-7.
Gastrostomy placement in patients who are unable to maintain their nutrition orally has been attempted using a variety of techniques over the past century. This includes surgical, endoscopic, and, more recently, percutaneous radiologically guided methods. Surgical gastrostomy placement was the method of choice for almost a century, but has since been superseded by both endoscopic and radiological placement. There are a number of indications for gastrostomy placement in clinical practice today, with fewer contraindications due to the recent innovations in technique placement and gastrostomy catheter type. We describe the technique of gastrostomy placement, which we use in our institution, along with appropriate indications and contraindications. In addition, we will discuss the wide variety of catheter types available and their perceived advantages. There remains some debate with regard to gastropexy performance and the use of primary gastrojejunal catheters, which we will address. In addition, we will discuss the advantages and disadvantages of the three major types of gastrostomy placement currently available (i.e., surgical, endoscopic, and radiological) and their associated complications.
在过去的一个世纪里,人们尝试了多种技术为无法通过口服维持营养的患者放置胃造口管。这包括外科手术、内镜检查,以及最近的经皮放射引导方法。外科胃造口管放置近一个世纪以来一直是首选方法,但后来已被内镜和放射放置方法所取代。如今在临床实践中有许多胃造口管放置的适应证,由于技术放置和胃造口管类型的最新创新,禁忌证较少。我们描述了我们机构使用的胃造口管放置技术,以及适当的适应证和禁忌证。此外,我们将讨论现有的各种导管类型及其公认的优点。关于胃固定术的实施和原发性胃肠造口导管的使用仍存在一些争议,我们将予以探讨。此外,我们将讨论目前可用的三种主要胃造口管放置类型(即外科手术、内镜检查和放射)的优缺点及其相关并发症。