Texas A&M School of Engineering Medicine, Houston, TX, USA; Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.
Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.
Ann Palliat Med. 2024 Sep;13(5):1183-1188. doi: 10.21037/apm-24-21. Epub 2024 Aug 27.
Inoperable malignant bowel obstruction, which results in chronic nausea, vomiting and abdominal pain, often requires nasogastric tube decompression. However, these tubes are often uncomfortable for patients and require hospitalization during the end-of-life care. Cervical esophago-gastric (CEG) decompression tubes are a potential palliative solution. The objective of this study is to present the outcomes of CEG tubes in 11 patients with malignant bowel obstruction.
We performed a retrospective review of patients requiring nasogastric tube decompression who received CEG decompression tubes for inoperable malignant bowel obstructions between 2016-2022. CEG tube placement was performed percutaneously through the left neck using a guidewire and an endoscopic technique.
The average age of patients was 58 years (31-72 years), with metastatic colorectal cancer (36.4%) and ovarian cancer (27.3%) being the most common causes of malignant bowel obstruction. All procedures were completed percutaneously, without requiring conversion to open procedures. The morbidity of the procedure was 27%, which included tube dislodgement, local cellulitis, or bleeding at the insertion site. None of the patients required reoperation, with most of the patients successfully treated conservatively. Most patients were discharged home after the procedure (82%); however, 45% were readmitted (mostly due to abdominal pain). Most patients (73%) were able to continue additional chemotherapy after tube placement. The average survival from cancer diagnosis was approximately six months, whereas the average survival after the procedure was about four months. No mortalities occurred due to CEG tube placement.
A CEG decompression tube is safe for patients with malignant bowel obstruction. The procedure allows patients to undergo additional chemotherapy and be discharged home with a more comfortable tube.
无法手术的恶性肠梗阻会导致慢性恶心、呕吐和腹痛，通常需要进行鼻胃管减压。然而，这些管子通常会让患者感到不适，并且在临终关怀期间需要住院治疗。颈段食管胃（CEG）减压管是一种潜在的姑息性解决方案。本研究的目的是介绍 11 例恶性肠梗阻患者接受 CEG 减压管治疗的结果。
我们对 2016 年至 2022 年间因无法手术的恶性肠梗阻需要接受鼻胃管减压的患者进行了回顾性研究，这些患者接受了 CEG 减压管治疗。CEG 管放置通过左颈部进行，使用导丝和内镜技术。
患者的平均年龄为 58 岁（31-72 岁），转移性结直肠癌（36.4%）和卵巢癌（27.3%）是恶性肠梗阻最常见的原因。所有手术均经皮完成，无需转为开放手术。该手术的发病率为 27%，包括管脱落、局部蜂窝织炎或插入部位出血。无患者需要再次手术，大多数患者经保守治疗成功治疗。大多数患者（82%）在手术后出院回家；然而，45%的患者再次入院（主要是由于腹痛）。大多数患者（73%）在放置管后能够继续接受额外的化疗。从癌症诊断到死亡的平均生存时间约为 6 个月，而手术后的平均生存时间约为 4 个月。没有患者因 CEG 管放置而死亡。
CEG 减压管对恶性肠梗阻患者是安全的。该手术允许患者接受额外的化疗，并在更舒适的情况下出院回家。
