Adam Hermanowicz, Ewa Matuszczak, Marta Komarowska, Elzbieta Jarocka-Cyrta, Jerzy Wojnar, Wojciech Debek, Department of Pediatric Surgery, Medical University of Bialystok, 15-001 Bialystok, Poland.
World J Gastroenterol. 2013 Nov 21;19(43):7696-700. doi: 10.3748/wjg.v19.i43.7696.
To analyzed whether laparoscopy-assisted percutaneous endoscopic gastrostomy (PEG) could be a valuable option for patients with complicated anatomy.
A retrospective analysis of twelve patients (seven females, five males; six children, six young adults; mean age 19.2 years) with cerebral palsy, spastic quadriparesis, severe kyphoscoliosis and interposed organs and who required enteral nutrition (EN) due to starvation was performed. For all patients, standard PEG placement was impossible due to distorted anatomy. All the patients qualified for the laparoscopy-assisted PEG procedure.
In all twelve patients, the laparoscopy-assisted PEG was successful, and EN was introduced four to six hours after the PEG placement. There were no complications in the perioperative period, either technical or metabolic. All the patients were discharged from the hospital and were then effectively fed using bolus methods.
Laparoscopy-assisted PEG should become the method of choice for gastrostomy tube placement and subsequent EN if PEG placement cannot be performed safely.
分析腹腔镜辅助经皮内镜胃造口术(PEG)是否可为解剖结构复杂的患者提供一种有价值的选择。
对 12 例因饥饿而需要肠内营养(EN)的脑瘫、痉挛性四肢瘫痪、严重脊柱后凸和间插器官的患者(7 名女性,5 名男性;6 名儿童,6 名年轻成人;平均年龄 19.2 岁)进行回顾性分析。由于解剖结构扭曲,所有患者均无法进行标准 PEG 放置。所有患者均符合腹腔镜辅助 PEG 手术条件。
在所有 12 例患者中,腹腔镜辅助 PEG 均成功完成,PEG 放置后 4 至 6 小时内开始进行 EN。围手术期无技术或代谢相关并发症。所有患者均出院,并通过推注法有效地进行喂养。
如果无法安全进行 PEG 放置,则腹腔镜辅助 PEG 应成为胃造口管放置和随后进行 EN 的首选方法。