Shike M
Gastroenterology-Nutrition Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Oncology (Williston Park). 1995 Jan;9(1):39-44; discussion 44, 47.
The use of safe and cost-effective endoscopic techniques for the placement of tubes in the gastrointestinal tract has led to increased utilization of long-term enteral feeding in patients with impaired GI function, including many cancer patients. Of an estimated 148,000 US patients who received long-term enteral feeding outside hospitals in 1992, 43% were cancer patients. The technique of percutaneous endoscopic gastrostomy is used primarily for enteral feeding, but can also be used to place wide tubes for drainage of an obstructed GI tract. Aspiration problems can be eliminated by endoscopic placement of a feeding tube directly into the jejunum (percutaneous endoscopic jejunostomy). Patients with advanced cancer who are not surgical candidates may benefit from an external GI bypass placed endoscopically, which allows drainage through a gastrostomy and feeding through a jejunostomy distal to the obstruction.
使用安全且经济高效的内镜技术在胃肠道放置管道，已使胃肠功能受损患者（包括许多癌症患者）对长期肠内营养的利用率有所提高。1992年，估计有14.8万美国患者在院外接受长期肠内营养，其中43%为癌症患者。经皮内镜下胃造口术主要用于肠内营养，也可用于放置粗管以引流梗阻的胃肠道。通过内镜将饲管直接置入空肠（经皮内镜下空肠造口术）可消除误吸问题。无法进行手术的晚期癌症患者可能受益于内镜下的体外胃肠旁路术，该手术可通过胃造口进行引流，并通过梗阻部位远端的空肠造口进行营养供给。
