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经皮经食管胃造瘘术的患者特征、手术及安全性结果:日本一项全国性数据库研究

Patient characteristics and procedural and safety outcomes of percutaneous transesophageal gastro-tubing: A nationwide database study in Japan.

作者信息

Nakama Rakuhei, Inoue Norihiko, Miyamoto Yoshihisa, Arai Yasunori, Kobayashi Tatsushi, Fushimi Kiyohide

机构信息

Department of Diagnostic Radiology, National Cancer Center Hospital East, Chiba, Japan.

Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan; Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.

出版信息

Surgery. 2024 Feb;175(2):368-372. doi: 10.1016/j.surg.2023.09.035. Epub 2023 Nov 7.

Abstract

BACKGROUND

Percutaneous transesophageal gastro-tubing (PTEG) is an alternative interventional procedure in cases where gastrostomy is not feasible. However, the safety and complication rates of PTEG have not yet been evaluated. We aimed to describe the characteristics of patients who underwent PTEG and investigate complications using a nationwide Japanese inpatient database.

METHODS

In this retrospective cohort study, we used the Diagnosis Procedure Combination database in Japan to identify patients who underwent PTEG from April 2012 to March 2020. The outcomes were the occurrence of complications, invasive treatment within 7 days after PTEG, and tube replacement within 14 days after PTEG. We statistically compared patient background, complication rates, and outcomes using PTEG indications.

RESULTS

A total of 3,684 patients underwent PTEG, which was performed in 1,455 patients for decompression and 2,193 patients for feeding. The patients' mean age was 73.1 years, and 62.1% were men. More patients in the decompression group had cancer than those in the feeding group. The overall number of complications was 47 cases (1.3%). The most common treatment administered after PTEG was red blood cell transfusion (3.9%), followed by early tube replacement (3.3%). As invasive treatments for PTEG complications, percutaneous drainage and transcatheter arterial embolization were required in 4 and 1 cases, respectively, and no cases required surgery.

CONCLUSION

We performed a descriptive study on PTEG using a nationwide database in Japan. This study also showed a low complication rate after PTEG in the real world. Our findings provide practical information on the safety of PTEG in Japan.

摘要

背景

经皮经食管胃造瘘术(PTEG)是在胃造瘘术不可行的情况下的一种替代性介入手术。然而,PTEG的安全性和并发症发生率尚未得到评估。我们旨在描述接受PTEG治疗的患者特征,并使用日本全国住院患者数据库调查并发症情况。

方法

在这项回顾性队列研究中,我们使用日本诊断程序组合数据库来识别2012年4月至2020年3月期间接受PTEG治疗的患者。观察结果为并发症的发生、PTEG术后7天内的侵入性治疗以及PTEG术后14天内的导管更换情况。我们使用PTEG的适应证对患者背景、并发症发生率和观察结果进行了统计学比较。

结果

共有3684例患者接受了PTEG治疗,其中1455例患者用于减压,2193例患者用于喂养。患者的平均年龄为73.1岁,男性占62.1%。减压组中患癌症的患者比喂养组更多。并发症总数为47例(1.3%)。PTEG术后最常进行的治疗是红细胞输血(3.9%),其次是早期导管更换(3.3%)。作为PTEG并发症的侵入性治疗,分别有4例和1例需要进行经皮引流和经导管动脉栓塞,无病例需要手术。

结论

我们使用日本全国数据库对PTEG进行了描述性研究。该研究还显示,在现实世界中PTEG术后并发症发生率较低。我们的研究结果提供了关于日本PTEG安全性的实用信息。

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