Kirberg Arturo, Diaz Biffret, Flores Eduardo, Romeroa Jorge, Varas Marcela, Contreras Karla
Endoscopy Center, Regional Hospital of Iquique, Iquique, Chile.
Endoscopy Center, Regional Hospital of Arica, Arica, Chile.
J Pediatr Surg. 2016 Apr;51(4):688-90. doi: 10.1016/j.jpedsurg.2016.01.003. Epub 2016 Jan 20.
The most common endoscopic gastrostomy technique is the "Pull-Through" or Gauderer-Ponsky technique. This is a transoral technique in which the internal bumper of the tube goes in through the esophagus. However this has been shown to be traumatic and often impossible in newborns and small for gestational age (SGA) patients, therefore a transabdominal technique must be used in this cases. We have developed a new transabdominal technique which combines two classical methods. This technique avoids the inconvenience of passing the internal bumper through the esophagus.
We have used this combined technique in five SGA patients. The technique consists of inserting a replacement tube using a Pull kit as installation device.
There were no complications during these five procedures and the patients were fed 2 hours later.
The main advantage of this technique is the use of kits that are already found in endoscopy units and endoscopists are familiar with. The disadvantage is the use of a balloon tube that can break or deflate.
最常见的内镜下胃造口术是“拉出式”或高德勒-庞斯基技术。这是一种经口技术，其中胃造口管的内部缓冲器经食管置入。然而，这已被证明具有创伤性，并且在新生儿和小于胎龄（SGA）患者中往往无法实施，因此在这些情况下必须采用经腹技术。我们开发了一种新的经腹技术，它结合了两种经典方法。该技术避免了将内部缓冲器经食管置入的不便。
我们在5例SGA患者中使用了这种联合技术。该技术包括使用Pull套件作为安装装置插入一根替换管。
这5例手术均无并发症发生，患者在术后2小时开始喂养。
该技术的主要优点是使用了内镜科室已有的套件，并且内镜医师对此很熟悉。缺点是使用的球囊管可能会破裂或瘪掉。
