Alliance Medical Italy, Lissone, Italy.
Gut Liver. 2010 Sep;4 Suppl 1(Suppl 1):S44-9. doi: 10.5009/gnl.2010.4.S1.S44. Epub 2010 Sep 10.
BACKGROUND/AIMS: Interventional radiologists have played a main role in the technical evolution of gastrostomy, from the first surgical/endoscopical approaches to percutaneous interventional procedures. This study evaluated the results obtained in a 12-year series.
During the period December 1996 to December 2008, 254 new consecutive gastrostomies and 275 replacement procedures were performed in selected patients. All of the cases were treated by a T-fastener gastropexy and tube placement. The procedures were assessed by analyzing indications, patient selection, duration of the procedures, and mortality.
All 254 first gastrostomies were successful; replacement procedures were also successfully performed. One (0.2%) patient with severe neurologic disorders died after the procedure without signs of procedure-related complications, and seven (1.3%) major complications occurred (four duodenal lesions with peritoneal leakage, two gastric bleedings, and one gastric lesion). Minor complications were easily managed; three tube ruptures were resolved.
This long-term series and follow-up showed that a group of interventional radiologist can effectively provide gastrostomy placement and long-term tube management. Percutaneous gastrostomy is less invasive than other approaches and it satisfies the needs even of high-risk patients.
背景/目的:介入放射学家在胃造口术的技术发展中发挥了主要作用,从最初的手术/内镜方法到经皮介入治疗。本研究评估了 12 年系列研究中的结果。
在 1996 年 12 月至 2008 年 12 月期间,对选定的患者进行了 254 例新的连续胃造口术和 275 例更换术。所有病例均采用 T 型夹胃固定和管放置治疗。通过分析适应证、患者选择、手术时间和死亡率来评估手术。
所有 254 例首次胃造口术均成功;更换手术也成功完成。一名(0.2%)有严重神经障碍的患者在手术后死亡,没有出现与手术相关的并发症迹象,7 例(1.3%)发生严重并发症(4 例十二指肠损伤伴腹膜渗漏,2 例胃出血,1 例胃损伤)。轻微并发症易于处理;有 3 例发生管破裂。
这项长期系列研究和随访表明,一组介入放射学家可以有效地提供胃造口术置管和长期管管理。经皮胃造口术比其他方法具有更小的侵入性,即使是高危患者也能满足需求。