Saini S, Mueller P R, Gaa J, Briggs S E, Hahn P F, Forman B H, Tung G A, Silverman S G, Lee M J, Morrison M C
Department of Radiology, Massachusetts General Hospital, Boston 02114.
AJR Am J Roentgenol. 1990 May;154(5):1003-6. doi: 10.2214/ajr.154.5.2108533.
We report our experience with radiologically guided percutaneous tube gastrostomy in 125 patients by using a gastropexy technique in which the anterior gastric wall is nonsurgically sutured to the anterior abdominal wall with percutaneously placed T-fasteners before catheter insertion. Short-term follow-up of up to 2 weeks was available in all patients. In 63 patients, long-term follow-up (greater than 4 weeks; average, 3.5 months; maximum, 1 year) was available. Catheter placement was successful in 124 (99%) of 125 patients, including three patients with anatomic changes after Bilroth II hemigastrectomy and two patients with failed endoscopic attempts. There were no deaths related to the procedure, and no patients required surgical intervention for complications attributable to the gastrostomy procedure. The 30-day mortality rate was 11% (n = 7). These deaths were due to cardiorespiratory arrest and were not attributable to the gastrostomy procedure. Major complications occurred in 1.6% (n = 1) and minor complications in 9.5% (n = 6). These results indicate that percutaneous gastrostomy with gastropexy is a safe and effective technique for placement of catheters in the stomach.
我们报告了125例患者经放射学引导的经皮胃造瘘术的经验，采用胃固定技术，即在插入导管前，通过经皮放置的T形钉将胃前壁非手术缝合至腹壁。所有患者均有长达2周的短期随访。63例患者有长期随访（超过4周；平均3.5个月；最长1年）。125例患者中有124例（99%）成功放置导管，包括3例毕罗Ⅱ式半胃切除术后有解剖结构改变的患者和2例内镜置入失败的患者。无与该操作相关的死亡病例，也无患者因胃造瘘术并发症需要手术干预。30天死亡率为11%（n = 7）。这些死亡是由于心肺骤停，并非胃造瘘术所致。主要并发症发生率为1.6%（n = 1），次要并发症发生率为9.5%（n = 6）。这些结果表明，经皮胃造瘘加胃固定术是一种安全有效的胃内导管置入技术。
