经皮内镜胃造瘘术置管后患者的食管切除术。

Esophagectomy in patients with prior percutaneous endoscopic gastrostomy tube placement.

机构信息

Grand Rapids Medical Educations Partners, General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA.

出版信息

Am J Surg. 2014 Mar;207(3):361-5; discussion 364-5. doi: 10.1016/j.amjsurg.2013.10.012. Epub 2013 Dec 19.

DOI:10.1016/j.amjsurg.2013.10.012

PMID:24418181

Abstract

BACKGROUND

The impact of preoperative percutaneous endoscopic gastrostomy (PEG) tube placement in patients undergoing esophagectomy is uncertain.

METHODS

A retrospective review was performed in consecutive patients who underwent esophagectomy. Patients were divided into groups based on whether or not they had preoperative PEG placement.

RESULTS

One hundred seventeen patients were studied, 102 without (PEG-) and 15 with PEG+ before PEG tube placement. The overall morbidity and mortality rates were 38% and 3%, respectively. The use of a gastric conduit was similar between groups (94% PEG- vs 87% PEG+, P = .27), and the presence of a PEG before PEG tube placement was not prohibitive in any case. Anastomotic leak rates were similar between groups (11% PEG- vs 15% PEG+, P = .65), and there were no leaks from previous PEG sites.

CONCLUSION

It appears that preoperative PEG tube placement has no adverse effect on the performance of esophagectomy and may be considered in highly selected patients with poor nutritional status.

摘要

背景

经皮内镜胃造口术（PEG）在食管癌患者术前的应用效果尚不确定。

方法

回顾性分析了连续接受食管癌切除术的患者。根据患者术前是否行 PEG 管置管，将其分为两组。

结果

本研究共纳入 117 例患者，其中 102 例未行 PEG（PEG-），15 例在术前行 PEG（PEG+）。总体并发症发生率和死亡率分别为 38%和 3%。两组胃管使用率相似（PEG-为 94%，PEG+为 87%，P=.27），且在任何情况下，PEG 术前置管均不是禁忌证。两组吻合口漏发生率相似（PEG-为 11%，PEG+为 15%，P=.65），且无吻合口漏来自先前的 PEG 部位。