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新型球囊尖端经皮内镜胃空肠造瘘管:一项初步研究。

A novel ballooned-tip percutaneous endoscopic gastrojejunostomy tube: a pilot study.

机构信息

Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.

出版信息

Gastrointest Endosc. 2013 Jul;78(1):154-7. doi: 10.1016/j.gie.2013.03.005. Epub 2013 Apr 24.

Abstract

BACKGROUND

The tip of currently available percutaneous endoscopic gastrojejunostomy (PEGJ) tubes frequently migrates back into the stomach.

OBJECTIVE

To study the safety of a novel, ballooned-tip, PEGJ tube and assess the risk of retrograde migration into the stomach within 3 weeks of placement.

DESIGN

Prospective clinical study (NCT01551095).

SETTING

Tertiary-care center.

PATIENTS

Seven patients who required post-pyloric feeding were included.

INTERVENTION

Placement of PEGJ feeding tubes.

MAIN OUTCOME MEASUREMENTS

Position of the PEGJ, abdominal radiograph findings, adverse events.

RESULTS

Seven patients underwent placement of self-propelled PEGJ tubes during the study period. Technical success was achieved in all patients (100%). All procedures were rated as technically simple, and jejunostomy tubes were placed in <5 minutes during all procedures. Abdominal radiographs showed that the jejunostomy tubes were in the jejunum in all 7 patients at both 1 and 3 weeks after tube placement.

LIMITATIONS

Small number of patients and short follow-up.

CONCLUSION

Ballooned-tip PEGJ feeding tubes were safe and easy to place. The presence of the balloon prevented migration into the stomach. Ballooned-tip PEGJ tubes have the potential to eliminate the need for hospital readmission and repeat endoscopies for retrograde tube migration, and this may result in large systemic cost savings.

摘要

背景

目前可用的经皮内镜胃空肠造口术(PEGJ)管的尖端经常会回退到胃中。

目的

研究新型带气囊尖端 PEGJ 管的安全性,并评估放置后 3 周内逆行迁移回胃的风险。

设计

前瞻性临床研究(NCT01551095)。

设置

三级保健中心。

患者

7 例需要幽门后喂养的患者纳入研究。

干预措施

放置 PEGJ 喂养管。

主要观察指标

PEGJ 的位置、腹部 X 线片结果、不良事件。

结果

7 例患者在研究期间接受了自推进 PEGJ 管的放置。所有患者均获得技术成功(100%)。所有操作均被评为技术简单,所有操作过程中,空肠造口管均在 5 分钟内完成放置。腹部 X 线片显示,在管放置后 1 周和 3 周时,7 例患者的空肠造口管均位于空肠。

局限性

患者数量少且随访时间短。

结论

带气囊尖端的 PEGJ 喂养管安全且易于放置。气囊的存在可防止迁移到胃中。带气囊尖端的 PEGJ 管有可能消除因逆行管迁移而需要再次住院和内镜检查的需要,这可能会带来巨大的系统成本节约。

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