Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1471, Houston, TX, 77401, USA.
Department of Medicine, Section of Gastroenterology, Baylor College of Medicine, 720 Cambridge St, 8th floor, Suite 8B, Houston, TX, 77030, USA.
Abdom Radiol (NY). 2021 Sep;46(9):4489-4498. doi: 10.1007/s00261-021-03115-7. Epub 2021 May 17.
To evaluate the safety and primary technical success rate of gastric decompression via percutaneous transabdominal gastrostomy (PTAG) or percutaneous transesophageal gastric (PTEG) catheter placement for management of malignant bowel obstruction (MBO). A secondary purpose was to evaluate the safety and success rate for PTAG catheter placement in patients with both MBO and ascites.
A single-institution retrospective review of 385 patients who underwent attempted decompression gastric catheter placement from March 2013 to August 2018 was performed. Medical records and imaging studies were reviewed. A subgroup of patients with concomitant MBO and ascites were identified. The primary outcome measures were procedural technical success and procedural complications.
394 decompression gastrostomy catheters were attempted from 2013 to 2018, n = 353 PTAG and n = 41 PTEG. The success rate was 95.5% (n = 337 of 353) for PTAG and 97.6% (n = 40 of 41) for PTEG. There were 63 total complications involving 47 (13.9%) patients following PTAG and 13 total complications involving 9 (22.5%) patients following PTEG, P = 0.16. For the subgroup of patients with MBO and ascites, the success rate was 94.8% (n = 182 of 192 patients), and there were 20 complications involving 17 (12.9%) of 132 patients.
Gastric decompression for patients with MBO via PTAG or PTEG catheter placement is associated with high success rates and low complications.
评估经皮经腹胃造口术（PTAG）或经皮经食管胃（PTEG）导管置管术用于治疗恶性肠梗阻（MBO）的安全性和主要技术成功率。次要目的是评估在同时患有 MBO 和腹水的患者中进行 PTAG 导管放置的安全性和成功率。
对 2013 年 3 月至 2018 年 8 月间尝试进行减压胃管放置的 385 例患者进行了单机构回顾性研究。对病历和影像学研究进行了回顾。确定了同时患有 MBO 和腹水的患者亚组。主要观察指标为程序技术成功率和程序并发症。
2013 年至 2018 年期间尝试了 394 个减压胃造口管，其中 353 个为 PTAG，41 个为 PTEG。PTAG 的成功率为 95.5%（337/353），PTEG 的成功率为 97.6%（40/41）。PTAG 后共有 63 例总并发症，涉及 47 例（13.9%）患者，PTEG 后共有 13 例总并发症，涉及 9 例（22.5%）患者，P=0.16。对于 MBO 和腹水的患者亚组，成功率为 94.8%（192/192 例），有 20 例并发症，涉及 132 例中的 17 例（12.9%）。
通过 PTAG 或 PTEG 导管置管术进行 MBO 患者的胃减压与高成功率和低并发症相关。
