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超声引导下胃造口管放置术:小儿患者术后并发症评估。

Ultrasound-Guided Gastrostomy Tube Placement: An Evaluation of Postoperative Complications in the Pediatric Population.

机构信息

Section of Pediatric Surgery, Department of Surgery, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA.

College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.

出版信息

J Laparoendosc Adv Surg Tech A. 2022 Aug;32(8):902-906. doi: 10.1089/lap.2021.0752. Epub 2022 Jun 7.

Abstract

Using ultrasound guidance has been demonstrated as a feasible alternative method for gastrostomy tube placement in the pediatric population. The aim of this study is to evaluate short- and long-term postoperative complications after ultrasound-guided gastrostomy tube placement (USGTP) and to compare them with complications after laparoscopic gastrostomy tube placement (LGTP). A retrospective chart review evaluated patients who underwent USGTP ( = 41) and LGTP ( = 120) at the same institution. Comparisons were made between the two groups in the context of demographics as well as 30-day and 6-month postoperative complications. A phone survey ( = 26) further identified USGTP complications potentially not captured in the electronic medical records. There were no significant differences in age, gender, and indication for procedure between the two groups. Chart review revealed that USGTP and LGTP had statistically comparable rates of emergency department (ED) visits for postoperative complications. Among USGTP patients, 8% had a recorded ED visit within 30 days of the operation and 13% presented to the ED within 6 months, compared with 6% and 11%, respectively, in the LGTP group ( = .65,  = .69). The USGTP phone survey reported total complications over an average postoperative follow-up time of 34.6 months (range 8-87) and revealed a total ED visit rate of 35%, which is comparable with rates reported in the literature for minimally invasive feeding tube placement. USGTP is a safe and feasible alternative option for gastrostomy tube placement in the pediatric population and it has postoperative complication rates that are comparable with LGTP.

摘要

在儿科人群中,超声引导已被证明是胃造口管放置的一种可行的替代方法。本研究旨在评估超声引导胃造口管放置(USGTP)后的短期和长期术后并发症,并将其与腹腔镜胃造口管放置(LGTP)后的并发症进行比较。一项回顾性图表审查评估了在同一机构接受 USGTP( = 41)和 LGTP( = 120)的患者。比较了两组患者在人口统计学特征以及 30 天和 6 个月术后并发症方面的差异。电话调查( = 26)进一步确定了电子病历中可能未记录的 USGTP 并发症。两组患者在年龄、性别和手术适应证方面无显著差异。图表审查显示,USGTP 和 LGTP 的术后并发症急诊就诊率具有统计学可比性。在 USGTP 患者中,8%的患者在术后 30 天内有记录的急诊就诊,13%的患者在术后 6 个月内就诊,而 LGTP 组分别为 6%和 11%( = .65, = .69)。USGTP 电话调查报告了平均术后随访时间为 34.6 个月(范围 8-87)的总并发症,并显示总急诊就诊率为 35%,与微创喂养管放置文献报道的发生率相当。USGTP 是儿科人群胃造口管放置的一种安全且可行的替代选择,其术后并发症发生率与 LGTP 相当。

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