Peters Robert Thomas, Balduyck Bram, Nour Shawqui
Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, LE1 5WW, UK.
Pediatr Surg Int. 2010 Jul;26(7):707-9. doi: 10.1007/s00383-010-2612-7. Epub 2010 May 8.
Gastrostomy is a commonly undertaken procedure in children. Methods for gastrostomy insertion have evolved and laparoscopy is commonly used to aid its insertion. The aim of this study is to review the outcome and complications of laparoscopic-assisted gastrostomy insertion.
A retrospective case note review of children undergoing gastrostomy insertion by a single surgeon from 1999 to 2007.
114 children underwent gastrostomy insertion, 68 males and 46 females, with a median age of 55 months (IQR 28-149 months). The majority were neurologically impaired. 98 underwent laparoscopic-assisted PEG (86%), 1 was converted to open procedure (0.9%) and 16 had standard PEG (14%). Median follow-up was 10.5 months with 90 children having their original gastrostomy changed to a button at a median interval of 7.4 months. Complications observed included new or deteriorating gastro-oesophageal reflux (GOR) (n = 16), infection (n = 9), granulation tissue (n = 11), tube dislodgement (n = 2) and intra-abdominal leakage of feed (n = 2). There were two gastrocolic fistulae which occurred in the standard PEG group.
The inadvertent formation of a gastrocolic fistula was avoided with the use of laparoscopy to aid PEG insertion.
胃造口术是儿童中常见的手术。胃造口术的插入方法不断发展，腹腔镜检查常用于辅助其插入。本研究的目的是回顾腹腔镜辅助胃造口术插入的结果和并发症。
对1999年至2007年由单一外科医生进行胃造口术插入的儿童进行回顾性病例记录审查。
114名儿童接受了胃造口术插入，其中男性68名，女性46名，中位年龄为55个月（四分位间距28 - 149个月）。大多数儿童有神经功能障碍。98名儿童接受了腹腔镜辅助经皮内镜下胃造口术（86%），1例转为开放手术（0.9%），16例进行了标准经皮内镜下胃造口术（14%）。中位随访时间为10.5个月，90名儿童在中位间隔7.4个月时将原胃造口改为纽扣式胃造口。观察到的并发症包括新出现或加重的胃食管反流（GOR）（n = 16）、感染（n = 9）、肉芽组织（n = 11）、导管移位（n = 2）和腹腔内喂养液渗漏（n = 2）。标准经皮内镜下胃造口术组出现了两例胃结肠瘘。
使用腹腔镜辅助经皮内镜下胃造口术插入可避免无意中形成胃结肠瘘。
