Department of Internal Medicine, The Catholic University of Korea College of Medicine, 505, Banpo-dong, Seocho-gu, Seoul, 137-070, Korea.
Dig Dis Sci. 2011 Jul;56(7):2024-9. doi: 10.1007/s10620-011-1570-9. Epub 2011 Jan 23.
The techniques of percutaneous endoscopic gastrostomy are classified as the pull and introducer methods. Peristomal infection is the most common procedure-related complication in the pull method.
The objective of this study was to compare procedure-related complications between the two methods and to assess the outcome of long-term use of the introducer method.
Between January 1999 and November 2009, 116 patients received percutaneous endoscopic gastrostomy at Seoul St. Mary's Hospital in Korea. Before June 2006, the pull method was used for all patients; since then, every patient had been treated using the introducer method. We compared outcomes and complications within 180 days of gastrostomy placement for the two methods.
The pull method was performed on 63 patients and the introducer method on 53 patients. The occurrence of peristomal infection within 30 days was significantly lower in the introducer method group than in the pull method group (1.9% vs. 36.5%, P = 0.001). Methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the major organisms isolated from the peristomal infection. The requirement for catheter reinsertion because of displacement, obstruction, or damage to the catheter between 30 and 180 days was significantly higher in the introducer method group than in the pull method group (40.5% vs. 0%, P = 0.001).
Our results suggest the superiority of the introducer method in terms of infection control. However, the balloon-type catheter is associated with problems such as balloon insufficiency in long-term use.
经皮内镜胃造口术的技术分为拉式和引入器方法。在拉式方法中，造口周围感染是最常见的与操作相关的并发症。
本研究旨在比较两种方法的与操作相关的并发症，并评估引入器方法长期使用的结果。
1999 年 1 月至 2009 年 11 月期间，韩国首尔圣玛丽医院有 116 名患者接受了经皮内镜胃造口术。在 2006 年 6 月之前，所有患者均采用拉式方法；此后，每位患者均采用引入器方法进行治疗。我们比较了两种方法在胃造口术后 180 天内的结果和并发症。
拉式方法用于 63 例患者，引入器方法用于 53 例患者。在 30 天内，引入器方法组的造口周围感染发生率明显低于拉式方法组（1.9%比 36.5%，P=0.001）。从造口周围感染中分离出的主要病原体是耐甲氧西林金黄色葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌。在 30 至 180 天期间，由于导管移位、阻塞或损坏而需要重新插入导管的情况，引入器方法组明显高于拉式方法组（40.5%比 0%，P=0.001）。
我们的结果表明引入器方法在控制感染方面具有优势。然而，球囊型导管在长期使用中存在球囊不足等问题。
