Gleeson N C, Hoffman M S, Fiorica J V, Roberts W S, Cavanagh D
Department of Obstetrics & Gynecology, University of South Florida, H. Lee Moffitt Cancer Center, Tampa.
Gynecol Oncol. 1994 Jul;54(1):19-22. doi: 10.1006/gyno.1994.1159.
In order to prevent the complications of long-term nasogastric suctioning and increase patient comfort, we have been using gastrostomy tubes (G-tubes) in gynecologic oncology patients who are deemed to be at risk for protracted postoperative bowel dysfunction. This study describes our patient selection criteria and evaluates the results with 35 MIC (Medical Innovation Corporation, Milpitas, CA) gastrostomy tubes inserted between September 1, 1992 and April 30, 1993. The procedure is technically easy and adds approximately 10 min to operating time. The tubes were well tolerated by the patients over periods ranging from 5 to 135 days. All tubes were used for postoperative gastric drainage and in addition, eight tubes were used for short-term enteral feeding. One patient with short bowel syndrome continued enteral nutritional supplementation at home. Twenty patients were discharged with their G-tubes in situ. Five of these patients required continuous gastric drainage because of obstruction of gastric emptying or small bowel by advanced tumor, and four of them were taking full liquids orally prior to discharge from the hospital. Gastrostomy tubes are convenient adjuncts to postoperative care of the gynecologic oncology patient and afford palliation with few complications to patients dying with bowel obstruction.
为防止长期鼻胃管抽吸的并发症并提高患者舒适度,我们一直在妇科肿瘤患者中使用胃造瘘管(G管),这些患者被认为术后存在长期肠道功能障碍的风险。本研究描述了我们的患者选择标准,并评估了1992年9月1日至1993年4月30日期间插入的35根MIC(医疗创新公司,加利福尼亚州米尔皮塔斯)胃造瘘管的使用结果。该操作在技术上很简单,手术时间大约增加10分钟。这些管子在5至135天的时间里患者耐受性良好。所有管子都用于术后胃引流,此外,8根管子用于短期肠内喂养。一名短肠综合征患者在家中继续进行肠内营养补充。20名患者出院时G管仍留在原位。其中5名患者因晚期肿瘤导致胃排空或小肠梗阻而需要持续胃引流,其中4名患者在出院前已能口服全流食。胃造瘘管是妇科肿瘤患者术后护理的方便辅助工具,对死于肠梗阻的患者能提供缓解且并发症少。