Shukla N K, Goel A K, Seenu V, Nanda R, Deo S V, Kriplani A K
Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi.
J Surg Oncol. 1994 Aug;56(4):217-20. doi: 10.1002/jso.2930560403.
Esophageal cancer often leads to total or near-total dysphagia, necessitating placement of nasogastric tubes for nutritional support. In patients with failed blind intubation or even failed fluoroscopic-guided tube placement, endoscopic guidance has a role to play. The catheter-over-guidewire technique is simple, safe, and easy to use. Over a period of 3 years, it was used in 28 patients who had esophageal cancer with absolute dysphagia. Successful placement of Levin tubes was achieved in 21 (75%) of these patients. Failure was more common in upper third lesions. The procedure was done on an outpatient basis, and no procedure-related complications were recorded in this series. To summarize, endoscopically assisted nasogastric tube placement is a useful option in esophageal cancer when blind intubation has failed, and it should be considered in preference to fluoroscopic assistance if endoscopic facilities are available.
食管癌常导致完全或近乎完全吞咽困难，需要放置鼻胃管以提供营养支持。对于盲插失败甚至透视引导下置管失败的患者，内镜引导可发挥作用。导丝引导导管技术简单、安全且易于操作。在3年的时间里，该技术应用于28例患有绝对吞咽困难的食管癌患者。其中21例（75%）成功置入了 Levin 管。上三分之一病变患者失败更为常见。该操作在门诊进行，本系列中未记录到与操作相关的并发症。总之，当盲插失败时，内镜辅助鼻胃管置入在食管癌患者中是一种有用的选择，并且如果有内镜设备，应优先考虑内镜辅助而非透视辅助。
