Kent Michael S, Awais Omar, Schuchert Matthew J, Adusumilli Prasad S, Keeley Samuel, Alvelo-Rivera Miguel, Landreneau Rodney J, Luketich James D
Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15232, USA.
Ann Surg. 2008 Aug;248(2):199-204. doi: 10.1097/SLA.0b013e3181820ca4.
To review our experience with pharyngostomy tubes used to manage complications following foregut surgery and to discuss technical aspects of insertion.
Cervical pharyngostomy tubes are percutaneously placed through the hypopharynx and directed into the stomach or small bowel. Historically, these tubes were placed during resection of head and neck cancer for postoperative nutrition. The technique may also be used to manage a variety of complications following esophagectomy or gastric surgery.
A retrospective review identified all patients who underwent pharyngostomy tube placement at the University of Pittsburgh Medical Center from 1995 to 2007. Indications, procedure-related complications, and duration of tube placement were recorded.
Thirty-eight patients were identified. Indications for tube placement were: access for enteral nutrition (n = 18), drainage of mediastinal abscess (n = 4), gastric decompression (n = 13), and other (n = 3). Procedure-related complications included: cellulitis (n = 1), esophagitis (n = 1), aspiration pneumonia (n = 1), and tube migration (n = 9). Duration of tube placement was 51 days (range 1-279). No major complications occurred.
Pharyngostomy tubes may be useful in the management of complications following esophageal or gastric surgery. They are more comfortable than nasogastric tubes and may be kept in place for several months if necessary. Bleeding or other major complications have not occurred in our experience.
回顾我们使用咽造口管处理前肠手术后并发症的经验，并讨论置管的技术要点。
颈段咽造口管经皮穿过下咽并导入胃或小肠。过去，这些管子是在头颈部癌切除术中放置用于术后营养支持。该技术也可用于处理食管切除或胃手术后的各种并发症。
一项回顾性研究确定了1995年至2007年在匹兹堡大学医学中心接受咽造口管置管的所有患者。记录置管指征、与操作相关的并发症及置管时间。
共确定38例患者。置管指征包括：肠内营养通路建立（n = 18）、纵隔脓肿引流（n = 4）、胃减压（n = 13）及其他（n = 3）。与操作相关的并发症包括：蜂窝织炎（n = 1）、食管炎（n = 1）、吸入性肺炎（n = 1）及导管移位（n = 9）。置管时间为51天（范围1 - 279天）。未发生重大并发症。
咽造口管在食管或胃手术后并发症的处理中可能有用。它们比鼻胃管更舒适，如果必要可留置数月。根据我们的经验，未发生出血或其他重大并发症。
