摘要
AIM: To elucidate the safety of percutaneous endoscopic gastrostomy(PEG) under steady pressure automatically controlled endoscopy(SPACE) using carbon dioxide(CO_2).METHODS: Nine patients underwent PEG with a modified introducer method under conscious sedation. A T-tube was attached to the channel of an endoscope connected to an automatic surgical insufflator. The stomach was inflated under the SPACE system. The intragastric pressure was kept between 4-8 mmH g with a flow of CO_2 at 35 L/min. Median procedure time, intragastric pressure, median systolic blood pressure, partial pressure of CO_2, abdominal girth before and immediately after PEG, and free gas and small intestinal gas on abdominal X-ray before and after PEG were recorded. RESULTS: PEG was completed under stable pneumostomach in all patients, with a median procedural time of 22 min. Median intragastric pressure was 6.9 mmH g and median arterial CO_2 pressure before and after PEG was 42.1 and 45.5 Torr(NS). The median abdominal girth before and after PEG was 68.1 and 69.6 cm(NS). A mild free gas image after PEG was observed in two patients, and faint abdominal gas in the downstream bowel was documented in two patients.CONCLUSION: SPACE might enable standardized pneumostomach and modified introducer procedure of PEG.
AIM: To elucidate the safety of percutaneous endoscopic gastrostomy(PEG) under steady pressure automatically controlled endoscopy(SPACE) using carbon dioxide(CO_2).METHODS: Nine patients underwent PEG with a modified introducer method under conscious sedation. A T-tube was attached to the channel of an endoscope connected to an automatic surgical insufflator. The stomach was inflated under the SPACE system. The intragastric pressure was kept between 4-8 mmH g with a flow of CO_2 at 35 L/min. Median procedure time, intragastric pressure, median systolic blood pressure, partial pressure of CO_2, abdominal girth before and immediately after PEG, and free gas and small intestinal gas on abdominal X-ray before and after PEG were recorded. RESULTS: PEG was completed under stable pneumostomach in all patients, with a median procedural time of 22 min. Median intragastric pressure was 6.9 mmH g and median arterial CO_2 pressure before and after PEG was 42.1 and 45.5 Torr(NS). The median abdominal girth before and after PEG was 68.1 and 69.6 cm(NS). A mild free gas image after PEG was observed in two patients, and faint abdominal gas in the downstream bowel was documented in two patients.CONCLUSION: SPACE might enable standardized pneumostomach and modified introducer procedure of PEG.