Pagan Alberto, Bianchi Alessandro, Martínez José Antonio, Jiménez Marina, Gonzalez Francisco Javier
Department of General Surgery, Hospital Universitario Son Espases, Palma De Mallorca, Spain.
Turk J Surg. 2018 Jan 3;34(2):155-157. doi: 10.5152/turkjsurg.2017.3211. eCollection 2018.
In cancer patients with tumors of the upper gastrointestinal tract, dysphagia and cachexia require gastrostomy or jejunostomy as the only options for enteral access for long-term feeding. In this article, the authors describe a modified placement of laparoscopic feeding jejunostomy applied during laparoscopic oncology layering technique. After performing an exploratory laparoscopy, a feeding jejunostomy is performed using a Foley silicon catheter, through an eyelet in the mesentery of the descending colon. After completing the introduction of the jejunal probe according to the Witzel technique, the intestinal segment of jejunum is attached to the internal sheath of the mesocolon using sutures polysorb 2/0, with the aim of removing the possible internal hernia and a jejunal torque that could cause an intestinal obstruction. There were no intraoperative complications or mortality. The technique described here provides most of the benefits of laparoscopic jejunostomy feeding, avoiding the possible internal hernia.
在上消化道肿瘤的癌症患者中，吞咽困难和恶病质使得胃造口术或空肠造口术成为长期肠内营养通路的唯一选择。在本文中，作者描述了一种在腹腔镜肿瘤分层技术中应用的改良腹腔镜喂养空肠造口术的放置方法。在进行探查性腹腔镜检查后，使用Foley硅胶导管通过降结肠系膜上的小孔进行喂养空肠造口术。按照维泽尔技术完成空肠探子的插入后，使用2/0聚乙醇酸缝线将空肠肠段固定于结肠系膜内鞘，目的是消除可能的内疝以及可能导致肠梗阻的空肠扭转。术中无并发症或死亡情况。这里描述的技术提供了腹腔镜空肠造口喂养的大部分益处，避免了可能的内疝。
