Iwase Ryota, Suzuki Yutaka, Yamanouchi Eigoro, Suzuki Norihiko, Imakita Tomonori, Tsutsui Nobuhiro, Odaira Hironori, Yanaga Katsuhiko
Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan; Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Department of Surgery, International University of Health and Welfare Hospital, Tochigi, Japan.
J Surg Res. 2018 Dec;232:470-474. doi: 10.1016/j.jss.2018.05.041. Epub 2018 Jul 25.
The management of gastric cancer causing gastric outlet obstruction and dilatation must include decompression of the stomach and intravenous nutrition. Percutaneous transesophageal gastrotubing (PTEG) is an effective technique for either gastric decompression or enteral nutrition. Here, we investigated the efficacy and safety of double PTEG (dPTEG), that is, using PTEG for both purposes simultaneously, in patients with gastric cancer.
Eleven patients with gastric outlet obstruction due to gastric cancer were admitted to our hospital between January 2015 and March 2017 and enrolled in this study. Each patient underwent dPTEG as soon as possible. After dPTEG tubes were placed, gastric decompression was started immediately and enteral nutrition was started within 1 d. Feeding and decompression through the double tubes were continued until the day before operation. Using data from these patients, we investigated the efficacy and safety of dPTEG.
dPTEG was performed successfully in all patients and no critical adverse effects were observed. Eight of the 11 patients underwent radical or palliative resection. Decompression of the stomach was achieved and nutritional status was significantly improved after dPTEG in all patients.
We conclude that dPTEG is a safe and effective management technique for patients with gastric outlet obstruction and gastric dilatation due to gastric cancer.
对于导致胃出口梗阻和扩张的胃癌，其治疗必须包括胃减压和静脉营养。经皮经食管胃造瘘术（PTEG）是一种用于胃减压或肠内营养的有效技术。在此，我们研究了双腔经皮经食管胃造瘘术（dPTEG），即同时将PTEG用于这两种目的，在胃癌患者中的疗效和安全性。
2015年1月至2017年3月期间，11例因胃癌导致胃出口梗阻的患者入住我院并纳入本研究。每位患者尽快接受dPTEG。放置dPTEG管后，立即开始胃减压，并在1天内开始肠内营养。通过双腔管进行喂养和减压持续至手术前一天。利用这些患者的数据，我们研究了dPTEG的疗效和安全性。
所有患者dPTEG均成功实施，未观察到严重不良反应。11例患者中有8例接受了根治性或姑息性切除。所有患者在dPTEG后实现了胃减压，营养状况显著改善。
我们得出结论，dPTEG对于因胃癌导致胃出口梗阻和胃扩张的患者是一种安全有效的治疗技术。
