Osera Shozo, Yano Tomonori, Odagaki Tomoyuki, Oono Yasuhiro, Ikematsu Hiroaki, Ohtsu Atsushi, Kaneko Kazuhiro
Endoscopy Division, Department of Gastroenterology and GI Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan.
Juntendo University Graduate School of Medicine, Tokyo, Japan.
Surg Endosc. 2015 Oct;29(10):2941-6. doi: 10.1007/s00464-014-4026-4. Epub 2014 Dec 17.
Percutaneous endoscopic gastrostomy (PEG) using the direct method is generally indicated for cancer patients. However, there are little available data about peritonitis related to this method. The aim of this retrospective analysis was to assess peritonitis related to PEG using the direct method in patients with cancer.
We assessed the prevalence of peritonitis and the relationship between peritonitis and patients' backgrounds, as well as the clinical course after peritonitis.
Between December 2008 and December 2011, peritonitis was found in 9 (2.1 %) of 421 patients. Of the 9 patients with peritonitis, 4 had received PEG prior to chemoradiotherapy. Emergency surgical drainage was required in 1 patient, and the remaining 8 recovered with conservative treatment. Peritonitis occurred within 8 days of PEG for 8 of the 9 patients and occurred within 2 days of suture removal for 4 of the 9 patients.
Peritonitis related to PEG using the direct method was less frequent for cancer patients. Peritonitis tended to occur within a few days after removal of securing suture and in patients with palliative stage.
直接法经皮内镜下胃造口术（PEG）一般适用于癌症患者。然而，关于该方法相关腹膜炎的可用数据很少。本回顾性分析的目的是评估癌症患者中与直接法PEG相关的腹膜炎情况。
我们评估了腹膜炎的患病率、腹膜炎与患者背景之间的关系以及腹膜炎后的临床病程。
在2008年12月至2011年12月期间，421例患者中有9例（2.1%）发生腹膜炎。在9例腹膜炎患者中，4例在放化疗前接受了PEG。1例患者需要紧急手术引流，其余8例经保守治疗康复。9例患者中有8例在PEG后8天内发生腹膜炎，9例患者中有4例在缝线拆除后2天内发生腹膜炎。
癌症患者中与直接法PEG相关的腹膜炎发生率较低。腹膜炎倾向于在固定缝线拆除后的几天内以及处于姑息阶段的患者中发生。
