Department of Gastroenterology, Division of Medicine, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan.
Department of Gastroenterology, Matsumoto City Hospital, Matsumoto, Japan.
Sci Rep. 2020 Nov 25;10(1):20551. doi: 10.1038/s41598-020-77553-6.
Percutaneous endoscopic gastrostomy (PEG), which is frequently used for nutrition management in patients having difficulty with oral intake, is considered a safe procedure. However, serious complications may occur depending on site of the puncture. This study aimed to clarify whether push method PEG construction at the posterior wall (PW) of the greater curvature (GC) had a higher risk of complications. We retrospectively investigated the relationship between puncture site at the PW of the GC and early acute complications in 540 patients receiving PEG. Early acute complications were defined as bleeding or perforation within 30 days after the PEG procedure. PEG-related complications were observed in 80 patients in total, with early acute complications detected in 42 patients. PEG construction at the PW of the GC in 12 cases exhibited a significantly higher occurrence of early acute complications versus PEG at other sites (41.7% vs. 7.0%, p = 0.001). Further, multivariate analysis revealed PW at the GC to be independently associated with early acute complications (OR 9.59, 95% CI 2.82-32.61; p = 0.0003). It may be desirable to avoid PEG at the PW of the GC. If performed, clinicians should pay careful attention to early acute complications.
经皮内镜胃造口术（PEG）常用于经口摄入困难的患者的营养管理，被认为是一种安全的手术。然而，根据穿刺部位的不同，可能会发生严重的并发症。本研究旨在阐明在胃大弯后壁（PW）进行推送式 PEG 构建是否有更高的并发症风险。我们回顾性调查了 540 例接受 PEG 的患者 PW 位于 GC 与早期急性并发症之间的关系。早期急性并发症定义为 PEG 术后 30 天内发生的出血或穿孔。总共观察到 80 例患者出现 PEG 相关并发症，其中 42 例出现早期急性并发症。与其他部位相比，12 例 PW 位于 GC 的 PEG 构建发生早期急性并发症的风险显著更高（41.7% vs. 7.0%，p=0.001）。进一步的多变量分析显示 PW 位于 GC 与早期急性并发症独立相关（OR 9.59，95%CI 2.82-32.61；p=0.0003）。避免在 GC 的 PW 进行 PEG 可能是可取的。如果进行了 PEG，临床医生应密切注意早期急性并发症。
