Chung R S, Schertzer M
Department of General Surgery, Cleveland Clinic Foundation, Ohio.
Am Surg. 1990 Mar;56(3):134-7.
In two comparable series of percutaneous endoscopic gastrostomy differing in only one technical detail, complications were significantly reduced by omitting traction on the gastrostomy tube to approximate the gastric to the abdominal wall. Radiologic studies show that traction shortened the tract (4.9 +/- 1.1 cm with traction, 11.6 +/- 2.3 cm without traction). In two patients with fasciitis, gross pericatheter leak of contrast into a short and patulous tract was observed. Tube extrusion and gastrointestinal bleeding from gastric ersion ulcers were eliminated when traction was not used. No peritonitis occurred as a result of not attempting to approximate the stomach to the abdominal wall. The data suggest that traction on the gastrostomy tube is not only unnecessary, but is the cause of many of the complications reported.
在两组仅在一个技术细节上存在差异的可比经皮内镜胃造口术系列中，通过省略胃造口管上的牵引以使胃贴近腹壁，并发症显著减少。放射学研究表明，牵引缩短了通道（牵引时为4.9±1.1厘米，无牵引时为11.6±2.3厘米）。在两名患有筋膜炎的患者中，观察到造影剂大量经导管漏入短而扩张的通道。不使用牵引时，可消除胃造口管脱出和胃翻转溃疡引起的胃肠道出血。未尝试使胃贴近腹壁未导致腹膜炎。数据表明，胃造口管上的牵引不仅不必要，而且是所报告的许多并发症的原因。
