Clinical application of percutaneous endoscopic gastrostomy with the Introducer method using ultrathin gastroscopy / 中国内镜杂志

ABSTRACT

Objective To evaluate the clinical application and security of percutaneous endoscopic gastrostomy (PEG) with the Introducer method using ultrathin gastroseopy in dysphagia patients. Methods Clinical data of 22 cases dysphagia patients implemented with PEG with the Introducer method using ultrathin gastroseopy or conventional gastroseopy were retrospectively analyzed, the clinical effect and the complication were observed. Results 22 patients underwent PEG with the Introducer method using conventional gastroscopy (6 cases) or ultrathin gastroscopy (16 cases). Among the 16 patients underwent PEG using ultrathin gastroseopy by transnasal or peroral approach, 2 cases with trimus by received radiotherapy for nasopharyngeal cancer and 14 cases with pharyngeal or esophagus narrowing, could not completed PEG by conventional gastroscopy. The average procedure time of PEG was (12.2 ± 2.9) min in conventional gastroscopy group and (11.8 ± 3.2) min in control group. No complications were observed in these patients, but the patients in ultrathin gastroseopy group reported less discomfort associated with the procedure. 17 patients with advanced nasopharyngeal carcinoma and esophagus cancer who received PEG could completely finished 6 cycles of concurrent chemoradiotherapy. Paired-sample t test of nutrition indicators (hemoglobin, albumin and RBC) before and after the treatment showed significant difference (P < 0.05). Conclusion PEG with the introducer method using ultrathin gastroseopy is a safe and effective method of enteral nutrition, Ultrathin gastroscopy reduces the discomfort of the procedure, especially in patients with serious trimus and pharyngeal or esophagus narrowing. For patients with advanced nasopharyngeal carcinoma, preventative PEG improved the tolerance of chemoradiotherapy,reduce the incidence of adverse events.