Stiegmann G, Goff J, VanWay C, Perino L, Pearlman N, Norton L
Department of Surgery, University of Colorado Health Sciences Center, Denver 80262.
Am J Surg. 1988 Jan;155(1):88-92. doi: 10.1016/s0002-9610(88)80263-0.
Percutaneous endoscopic gastrostomy in 23 patients was compared with operative gastrostomy in 25 patients in a prospective randomized fashion. Procedure-related morbidity occurred in five patients in each group. Tube feeding was initiated within 48 hours in 96 percent of the percutaneous endoscopic gastrostomy group and in 82 percent of the operative gastrostomy group (p less than 0.1). There were no deaths in the percutaneous endoscopic gastrostomy group, but two patients in the operative gastrostomy group died within 30 days of operation (p less than 0.1). Neither death appeared directly attributable to gastrostomy placement. The cost for a percutaneous endoscopic gastrostomy was less than that of an operative gastrostomy ($757 versus $1,446); however, if endoscopically placed tubes required replacement, as was seen in six patients, total percutaneous endoscopic gastrostomy cost increased to $1,198. Definitive conclusions regarding the superiority of one technique over the other cannot be drawn from this data. Trends favoring the use of percutaneous endoscopic gastrostomy merit continued study.
对23例行经皮内镜下胃造口术的患者与25例行手术胃造口术的患者进行了前瞻性随机对照研究。两组各有5例患者出现与手术相关的并发症。经皮内镜下胃造口术组96%的患者在48小时内开始管饲，手术胃造口术组为82%（P<0.1）。经皮内镜下胃造口术组无死亡病例，但手术胃造口术组有2例患者在术后30天内死亡（P<0.1）。两例死亡似乎均与胃造口术的放置无直接关系。经皮内镜下胃造口术的费用低于手术胃造口术（757美元对1446美元）；然而，如6例患者所示，如果内镜放置的管子需要更换，经皮内镜下胃造口术的总费用增加到1198美元。从这些数据中无法得出一种技术优于另一种技术的确切结论。支持使用经皮内镜下胃造口术的趋势值得继续研究。
