Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital (CHUV), 1011, Lausanne, Switzerland.
Eur Arch Otorhinolaryngol. 2011 Apr;268(4):623-9. doi: 10.1007/s00405-010-1412-y. Epub 2010 Nov 3.
The aim of this study was to review our experience in percutaneous endoscopic gastrostomy (PEG) performed in patients with cancer of the upper aerodigestive tract. Descriptive retrospective study of 142 patients (115 males, 27 females), mean age 62.4 years (25-84 years), with head and neck or esophageal cancer, who underwent PEG tube insertion between January 2006 and December 2008. The studied parameters were indications, success rate, rate and type of complications, and their management. Percutaneous endoscopic gastrostomy was inserted before chemoradiation therapy in 80% and during or after cancer treatment in 20% of the patients. PEG placement was possible in 137 patients (96%). Major complications were observed in 9 (7%) and minor complications in 22 (17%) of the 137 patients. Seven of the 9 patients with a major complication needed revision surgery. The mortality directly related to the procedure was 0.7%. Percutaneous endoscopic gastrostomy tube insertion has a high success rate. In patients with upper aerodigestive tract cancer, PEG should be the first choice for enteral nutrition when sufficient oral intake is not possible. Although apparently easy, the procedure may occasionally lead to severe complications. Therefore, a strict technique and knowledge of clinical signs of possible complications are mandatory.
本研究旨在回顾我们在经皮内镜胃造口术（PEG）治疗上消化道癌症患者方面的经验。这是一项回顾性描述性研究，共纳入 142 例患者（男性 115 例，女性 27 例），平均年龄 62.4 岁（25-84 岁），包括头颈部或食管癌症患者，这些患者在 2006 年 1 月至 2008 年 12 月期间接受了 PEG 管插入术。研究参数包括适应证、成功率、并发症发生率和类型，以及其处理方法。80%的患者在放化疗前、20%的患者在癌症治疗期间或之后进行了经皮内镜胃造口术。137 例患者（96%）成功进行了 PEG 置管。137 例患者中有 9 例（7%）出现严重并发症，22 例（17%）出现轻微并发症。9 例严重并发症患者中有 7 例需要进行修正手术。与该操作直接相关的死亡率为 0.7%。经皮内镜胃造口术置管成功率高。在上消化道癌症患者中，当无法进行充分的口服摄入时，PEG 应作为肠内营养的首选方法。尽管该操作看似简单，但偶尔可能会导致严重的并发症。因此，严格的技术和对可能并发症的临床征象的了解是必要的。
