Sriram K, Peterson J, Bawani M H
Department of Surgery, University of Health Sciences, Chicago Medical School, Illinois.
Am Surg. 1989 Aug;55(8):498-500.
In an attempt to facilitate long-term care and patient acceptance of gastrostomy feeding, the technique of permanent Janeway gastrostomy was modified. Using an auto-stapling device, a full-thickness gastric tube (6 cm long and 1.5 cm in diameter at its base) is created from the anterior wall of the stomach, based on the greater curve, with special attention to its vasculature. The base is invaginated into the stomach wall to create a tight valve. After skin closure, the terminal 1 cm is excised and the mucosa is sutured flush with the skin. A #10 French tube is inserted and positioned perpendicularly. A gastrostomy thus created will allow intermittent cannulation without leakage of gastric contents. Results of this procedure in 26 patients show a postoperative wound infection incidence of 3.8 per cent. With a mean follow up of 257 days, the gastrostomy was continent in 87 per cent of patients.
为了便于长期护理以及患者接受胃造口喂养，对永久性詹韦胃造口术进行了改良。使用自动吻合器，从胃前壁沿大弯处制作一个全层胃管（长6厘米，基部直径1.5厘米），特别注意其血管分布。将基部内翻入胃壁以形成紧密的瓣膜。皮肤缝合后，切除末端1厘米，将黏膜与皮肤齐平缝合。插入一根10号法国导管并垂直放置。这样形成的胃造口将允许间歇性插管而不会有胃内容物漏出。该手术在26例患者中的结果显示术后伤口感染发生率为3.8%。平均随访257天，87%的患者胃造口无内容物漏出。
