Cao Jun, He Yang, Liu Hong-Qiang, Wang Sai-Bo, Zhao Bao-Cheng, Cheng Ying-Sheng
Hepatogastroenterology. 2015 Mar-Apr;62(138):319-22.
BACKGROUND/AIMS: For patients with complete malignant pharyngoesophageal obstruction (CMPO), percutaneous radiologic gastrostomy (PRG) under ultrasound/CT guidance can complicate it to cause failure due to unsatisfied stomach filling. In this study, we retrospectively investigated whether PRG via nasopharyngeal intubation is feasible and effective for these patients.
PRG via nasopharyngeal intubation was attempted in 21 patients with CMPO (mean 70.8 ± 8.23 years). The technique comprised a dilation of the stomach via nasopharyngeal intubation using a catheter, followed by fluoroscopically guided puncture and gastrostomy tube placement. Complications including hemorrhage, peritonitis, gastrojejunocolic fistula, infection of puncture site, tube blocking and outleakage was observed during and after the procedure.
A 5F catheter was successfully inserted to the stomach under fluoroscopical guidance and subsequent PRG was performed in all 21 patients. Minor complications occurred in 14.3% patients including mild infection of the fistula in 1, tube blocking in 1 and unexpected tube drawing out in 1. Follow-up nutrition indexes revealed obvious improved nutrition compared to before PRG (P < 0.05).
PRG via nasopharyngeal intubation was simple, feasible and effective for patients with CMPO.
背景/目的：对于完全性恶性咽食管梗阻（CMPO）患者，超声/CT引导下的经皮放射学胃造口术（PRG）可能因胃充盈不满意而导致失败并引发并发症。在本研究中，我们回顾性调查了经鼻咽插管进行PRG对这些患者是否可行且有效。
对21例CMPO患者（平均年龄70.8±8.23岁）尝试经鼻咽插管进行PRG。该技术包括使用导管经鼻咽插管扩张胃，随后在荧光透视引导下穿刺并放置胃造口管。在手术期间及术后观察包括出血、腹膜炎、胃空肠结肠瘘、穿刺部位感染、导管堵塞和渗漏等并发症。
在荧光透视引导下成功将一根5F导管插入胃内，随后对所有21例患者进行了PRG。14.3%的患者出现轻微并发症，包括1例瘘管轻度感染、1例导管堵塞和1例意外拔管。随访营养指标显示，与PRG前相比，营养状况有明显改善（P<0.05）。
经鼻咽插管进行PRG对CMPO患者简单、可行且有效。
