Bäck Leif J J, Benders Alexander, Pietarinen Petra, Keski-Säntti Harri, Markkanen-Leppänen Mari, Udd Marianne, Halttunen Jorma, Mäkitie Antti A, Kylänpää Leena
Departments of Otorhinolaryngology - Head and Neck Surgery.
Acta Otolaryngol. 2014 Jul;134(7):760-7. doi: 10.3109/00016489.2014.895040. Epub 2014 May 5.
Percutaneous endoscopic gastrostomy (PEG) tube placement by an otorhinolaryngologist-head and neck surgeon is a feasible procedure with logistical advantages for the patient. Patient selection, co-morbidities, and the prognosis of the underlying disease are factors determining the outcome. Patient evaluation by a multidisciplinary team, with a gastroenterologist surgeon as a technical adviser, is proposed.
PEG tube placement offers an alternative to enteral nutrition. We aimed to analyze complication rates after PEG tube placement in order to evaluate the changed management policy.
This was a retrospective review of complication rates in two patient cohorts with consecutive PEG tube placement at the Departments of Otorhinolaryngology - Head and Neck Surgery (group I, n = 120) and Surgery (group II, n = 172) at Helsinki University Central Hospital, Helsinki, Finland. Data were collected on the patients' age, sex, preoperative condition, tumor site and stage, preoperative laboratory parameters, coexisting medical diagnoses, indication and date for PEG tube placement, complications, time of PEG use, follow-up time, and clinical status at the last follow-up.
The only baseline differences between the cohorts were a higher ASA classification and fewer prophylactic PEG tubes in group II. The rate of major complications was 7.5% in group I and 13.9% in group II; in group I the rate of minor complications was 25%, compared with 15% in group II; and the procedure-related mortality rate was 0.8% in group I and 0.5% in group II. The differences were not significant (p = 0.105-0.795).
由耳鼻喉科-头颈外科医生进行经皮内镜下胃造口术（PEG）置管对患者而言是一种可行的手术，具有后勤保障优势。患者选择、合并症及基础疾病的预后是决定结果的因素。建议由多学科团队对患者进行评估，胃肠病学外科医生作为技术顾问。
PEG置管为肠内营养提供了一种替代方法。我们旨在分析PEG置管后的并发症发生率，以评估管理政策的变化。
这是一项对芬兰赫尔辛基大学中心医院耳鼻喉科-头颈外科（第一组，n = 120）和外科（第二组，n = 172）连续进行PEG置管的两个患者队列并发症发生率的回顾性研究。收集了患者的年龄、性别、术前状况、肿瘤部位和分期、术前实验室参数、并存的医学诊断、PEG置管的指征和日期、并发症、PEG使用时间、随访时间以及最后一次随访时的临床状况等数据。
两组之间唯一的基线差异是第二组的美国麻醉医师协会（ASA）分级较高且预防性PEG管较少。第一组的主要并发症发生率为7.5%，第二组为13.9%；第一组的轻微并发症发生率为25%，而第二组为15%；第一组的手术相关死亡率为0.8%，第二组为0.5%。差异无统计学意义（p = 0.105 - 0.795）。
