Single endoscopist-performed percutaneous endoscopic gastrostomy tube placement
Single endoscopist-performed percutaneous endoscopic gastrostomy tube placement
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DOI：
10.3748/wjg.v19.i26.4172
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发表时间：
2013-07-14
影响因子：
4.3
通讯作者：
Erdogan, Askin
中科院分区：
文献类型：
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作者：
Erdogan, Askin
目的：探讨内镜医师单独行经皮内镜胃造口术（PEG）是否安全，并将PEG并发症与文献报道的并发症进行比较。方法：对2001年6月至2011年8月在巴斯肯特大学阿拉尼亚教学与研究中心接受聚乙二醇植入的患者进行回顾性评估。首次由单一内窥镜医师放置PEG的患者被纳入研究。采用拉法进行PEG。评估所有患者的PEG适应症、PEG引起的主要和次要并发症、营养状况、c反应蛋白（CRP）水平以及在PEG之前使用抗生素治疗或抗生素预防。同时还评估了合并症、死亡率、死亡时间和死亡原因。研究了聚乙二醇去除的原因和聚乙二醇持续时间。结果：62例患者在本研究中首次接受了PEG手术。8名由2名内窥镜医师进行PEG植入的患者未被纳入研究。共调查了54例患者。患者平均年龄69.9岁。PEG最常见的适应症是脑梗死，大约三分之二的患者发生脑梗死。平均白蛋白水平为3.04±0.7 g/dL， 76.2%的患者白蛋白水平低于正常值。90.6%的患者术前CRP水平较高。大约三分之二的患者在PEG手术前接受了抗生素预防或治疗感染。所有患者的死亡率与手术过程无关。埋藏保险杠综合征是唯一的主要并发症，发生在第三年。在这种情况下，通过手术取出PEG并放置新的PEG管。轻微并发症8例（15.1%），其中伤口感染6例（11.1%）。所有伤口感染，除一人经抗生素治疗后痊愈。2例患者出现PEG部位出血，1例采用初步缝合，另1例采用新鲜冷冻血浆输注。结论：主要和次要并发症的发生率与文献相符。这一发现可能值得注意，特别是在发展中国家。(三)2013年白石登。版权所有。
AIM: To investigate whether single endoscopist-performed percutaneous endoscopic gastrostomy (PEG) is safe and to compare the complications of PEG with those reported in the literature.METHODS: Patients who underwent PEG placement between June 2001 and August 2011 at the Baskent University Alanya Teaching and Research Center were evaluated retrospectively. Patients whose PEG was placed for the first time by a single endoscopist were enrolled in the study. PEG was performed using the pull method. All of the patients were evaluated for their indications for PEG, major and minor complications resulting from PEG, nutritional status, C-reactive protein (CRP) levels and the use of antibiotic treatment or antibiotic prophylaxis prior to PEG. Comorbidities, rates, time and reasons for mortality were also evaluated. The reasons for PEG removal and PEG duration were also investigated.RESULTS: Sixty-two patients underwent the PEG procedure for the first time during this study. Eight patients who underwent PEG placement by 2 endoscopists were not enrolled in the study. A total of 54 patients were investigated. The patients' mean age was 69.9 years. The most common indication for PEG was cerebral infarct, which occurred in approximately two-thirds of the patients. The mean albumin level was 3.04 +/- 0.7 g/dL, and 76.2% of the patients' albumin levels were below the normal values. The mean CRP level was high in 90.6% of patients prior to the procedure. Approximately two-thirds of the patients received antibiotics for either prophylaxis or treatment for infections prior to the PEG procedure. Mortality was not related to the procedure in any of the patients. Buried bumper syndrome was the only major complication, and it occurred in the third year. In such case, the PEG was removed and a new PEG tube was placed via surgery. Eight patients (15.1%) experienced minor complications, 6 (11.1%) of which were wound infections. All wound infections except one recovered with antibiotic treatment. Two patients had bleeding from the PEG site, one was resolved with primary suturing and the other with fresh frozen plasma transfusion.CONCLUSION: The incidence of major and minor complications is in keeping with literature. This finding may be noteworthy, especially in developing countries. (C) 2013 Baishideng. All rights reserved.