De Bernardis Gaston, Mayr Johannes
Department of Pediatric Surgery, University Childrens Hospital Basel, Basel, Switzerland.
Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):360-1. doi: 10.1097/SLE.0b013e31828e3867.
The aim of the study was to present the first case of replacement of a string jejunostomy with an enteroscopic percutaneous technique after the string was lost. The replaceable string jejunostomy is a well-established method for the enteral feeding in patients where the swallowing process is impaired and gastroesophageal reflux impedes the option of a gastrostomy. In the frequent case of obstruction, rupture or malfunction of the jejunostomy, it is easily replaced in an outpatient setting without anesthesia, with the help of the string that holds the tip of the feeding tube in place. In our case the string was lost.
The jejunostomy was replaced with a fully percutaneous technique with the help of a pediatric cystoscope.
This technique is well practicable and obviated the need for a laparotomy in a polymorbid patient.
The technique seems promising, but we report an anecdotal case description. Further experience is needed to investigate its safety.
本研究的目的是呈现首例在空肠造口管丢失后采用经肠镜经皮技术更换空肠造口管的病例。可更换导丝空肠造口术是一种成熟的方法，用于吞咽过程受损且胃食管反流妨碍胃造口术选择的患者进行肠内喂养。在空肠造口管频繁出现梗阻、破裂或功能障碍的情况下，借助将喂食管尖端固定在位的导丝，可在门诊无麻醉的情况下轻松更换。在我们的病例中，导丝丢失了。
借助小儿膀胱镜，采用完全经皮技术更换空肠造口管。
该技术切实可行，避免了在一位患有多种疾病的患者身上进行剖腹手术。
该技术似乎很有前景，但我们报告的是一则病例描述。需要更多经验来研究其安全性。
