Department of Surgery, Yokohama City University, School of Medicine 3-9, Fukuura, Kanazawa-ku, Yokohama city, 236-0004, Japan.
BMC Gastroenterol. 2011 Jan 31;11:8. doi: 10.1186/1471-230X-11-8.
We developed a skin-level jejunostomy tube (SLJT) procedure for patients undergoing esophagectomy using a skin-level gastrostomy tube (G-tube) (Entristar™; Tyco Healthcare, Mansfield, Mass), in order to improve their nutrition status and quality of life (QOL). We describe the procedure and the adverse effects of SLJT in patients with esophageal cancer (EC).
Over a 24-month period (March 2008 to March 2010), there were 16 patients (mean age: 61.8 years; age range: 49-75 years; 15 men, 1 woman) who had Stage II or III EC. Primary jejunostomy was performed under general anesthesia during esophagectomy. The technical success and the immediate and delayed complications of the procedure were recorded. JEJUNOSTOMY TECHNIQUES: SLJT placement using the G-tube (20Fr) was performed 20 cm from the Treitz ligament on the side opposing the jejunal mesenterium. The internal retention bolster was exteriorized through an incision in the abdominal wall. A single purse string suture using a 4-0 absorbable suture was performed. The internal retention bolster was then inserted into the jejunal lumen via the small incision. The intestine adjacent to the tube was anchored to the peritoneum using a single stitch.
The SLJT was successfully inserted in all 16 patients. No early complications were documented. Follow-up for a median of 107 days (range, 26-320 days) revealed leakage to the skin in four patients, including superficial wound infections in two patients. There were no cases of obstruction of the tube or procedure-related death.
This SLJT placement technique using the G-tube is a safe procedure in patients with EC and allows the creation of a long-term feeding jejunostomy.
我们开发了一种经皮空肠造口术（SLJT），用于接受食管切除术的患者，该术使用经皮胃造口术（G 管）（Entristar™；泰科医疗，曼斯菲尔德，马萨诸塞州），以改善他们的营养状况和生活质量（QOL）。我们描述了该程序以及食管癌（EC）患者的 SLJT 不良影响。
在 24 个月的时间（2008 年 3 月至 2010 年 3 月）中，有 16 名患者（平均年龄：61.8 岁；年龄范围：49-75 岁；15 名男性，1 名女性）患有 II 期或 III 期 EC。在食管切除术中，全身麻醉下进行原发性空肠造口术。记录该程序的技术成功率以及即时和延迟并发症。
在与空肠系膜相对的侧方，Treitz 韧带下方 20cm 处使用 G 管（20Fr）进行 SLJT 放置。内部保留塞子通过腹壁切口引出。使用 4-0 可吸收缝线进行单荷包缝线。然后通过小切口将内部保留塞子插入空肠腔。用单个缝线将邻近管的肠固定到腹膜上。
16 名患者均成功插入 SLJT。未记录到早期并发症。中位随访 107 天（范围，26-320 天）显示 4 名患者出现皮肤漏液，其中 2 名患者出现浅表伤口感染。无管腔阻塞或与该程序相关的死亡病例。
在 EC 患者中，使用 G 管的这种 SLJT 放置技术是一种安全的手术，可创建长期喂养的空肠造口术。
