胃十二指肠溃疡为临床较为常见疾病,而穿孔是其常见的并发症之一。胃十二指肠溃疡穿孔(perforation of gastroduodenal ulcer,PGDU)发病急、病情重、变化快[1,2],为普外科常见急腹症。当前对于PGDU一般行手术治疗,传统开腹修补手术患者...胃十二指肠溃疡为临床较为常见疾病,而穿孔是其常见的并发症之一。胃十二指肠溃疡穿孔(perforation of gastroduodenal ulcer,PGDU)发病急、病情重、变化快[1,2],为普外科常见急腹症。当前对于PGDU一般行手术治疗,传统开腹修补手术患者并发症较多、手术切口大、所承受痛苦多。展开更多
Background/Purpose: Gastrostomy tube insertion is frequently performed in children. Percutaneous endoscopic gastrostomy (PEG) insertion, considered by many to be the “gold standard,”is unavoidably associated with a ...Background/Purpose: Gastrostomy tube insertion is frequently performed in children. Percutaneous endoscopic gastrostomy (PEG) insertion, considered by many to be the “gold standard,”is unavoidably associated with a risk of intestinal perforation and frequently requires a second anesthetic for its replacement with a low-profile “button.”We hypothesized that a laparoscopic technique with low-pressure insufflation would yield comparable outcomes, a lower procedural complication rate, and require fewer anesthetics per patient. Methods: A retrospective review of all surgeon-placed gastrostomy tubes (exclusive of those associated with fundoplication or other procedures)-between January 2002 and December 2003 was undertaken. Data collected included type of procedure (PEG vs laparoscopic), indication, patient demographics (including neurologic comorbidity), operative time, complications (procedure-specific and nonspecific), and number of procedural anesthetics to “achieve”a low-profile tube. Groups were compared by univariate and multiple logistic regression analyses. Results: One hundred nineteen gastrostomy tubes (26 laparoscopic = 21.8%) were inserted. The PEG and laparoscopic gastrostomy groups were comparable from the perspectives of age, size, indications for tube placement, and operative time. The complication rate after PEG placement was significantly higher than after LG (14%vs 7.7%; P =. 023), and 72 (77.4%) of PEG patients required a second anesthetic for tube change. Conclusions: Laparoscopic gastrostomy tube insertion is safe and easy to perform, with outcomes comparable to that of PEG tube insertion. It obviates the need for a second procedural anesthetic and may emerge as the gold standard for gastrostomy tube placement.展开更多
文摘胃十二指肠溃疡为临床较为常见疾病,而穿孔是其常见的并发症之一。胃十二指肠溃疡穿孔(perforation of gastroduodenal ulcer,PGDU)发病急、病情重、变化快[1,2],为普外科常见急腹症。当前对于PGDU一般行手术治疗,传统开腹修补手术患者并发症较多、手术切口大、所承受痛苦多。
文摘Background/Purpose: Gastrostomy tube insertion is frequently performed in children. Percutaneous endoscopic gastrostomy (PEG) insertion, considered by many to be the “gold standard,”is unavoidably associated with a risk of intestinal perforation and frequently requires a second anesthetic for its replacement with a low-profile “button.”We hypothesized that a laparoscopic technique with low-pressure insufflation would yield comparable outcomes, a lower procedural complication rate, and require fewer anesthetics per patient. Methods: A retrospective review of all surgeon-placed gastrostomy tubes (exclusive of those associated with fundoplication or other procedures)-between January 2002 and December 2003 was undertaken. Data collected included type of procedure (PEG vs laparoscopic), indication, patient demographics (including neurologic comorbidity), operative time, complications (procedure-specific and nonspecific), and number of procedural anesthetics to “achieve”a low-profile tube. Groups were compared by univariate and multiple logistic regression analyses. Results: One hundred nineteen gastrostomy tubes (26 laparoscopic = 21.8%) were inserted. The PEG and laparoscopic gastrostomy groups were comparable from the perspectives of age, size, indications for tube placement, and operative time. The complication rate after PEG placement was significantly higher than after LG (14%vs 7.7%; P =. 023), and 72 (77.4%) of PEG patients required a second anesthetic for tube change. Conclusions: Laparoscopic gastrostomy tube insertion is safe and easy to perform, with outcomes comparable to that of PEG tube insertion. It obviates the need for a second procedural anesthetic and may emerge as the gold standard for gastrostomy tube placement.
