Bolder, Ulrich and Scherer, Marcus N. and Schmidt, Thorsten and Hornung, Matthias and Schlitt, Hans-Juergen and Vogel, Peter (2010) Percutaneous laparoscopic assisted gastrostomy (PLAG)-a new technique for cases of pharyngoesophageal obstruction. LANGENBECKS ARCHIVES OF SURGERY, 395 (8). pp. 1107-1113. ISSN 1435-2443,
Full text not available from this repository. (Request a copy)Abstract
Purpose Percutaneous endoscopic gastrostomy (PEG) is the preferable method to provide enteral nutrition for a longer time period. Safe placement of a PEG tube requires passage of the esophagus and transillumination of the stomach through the abdominal wall. Surgical placement of a PEG tube has been shown to be feasible although the local complication rate ranges above the endoscopic procedure. We are presenting a new technique (percutaneous laparoscopically assisted gastrostomy, PLAG) to provide enteral access for patients with pharyngoesophageal obstruction not suitable for PEG placement. Methods We have developed a laparoscopic method that allows full control of the stoma location at the anterior gastric wall. The tube has a deployable bumper mechanism, which can be inserted through a minimal gastric incision. Combined with the fixation by transcutaneous sutures, the risk for leakage or dislodgement is low. Results Fifty-one PLAGs were inserted in 45 male and six female patients suffering from pharyngoesophageal obstruction due to malignancy. Patients were referred after unsuccessful endoscopic PEG placement (n=39) or received their PLAG when they underwent staging laparoscopy (n=12). Success rate was 96.2%. No procedure-related mortality was observed. Infectious complications occurred in three (5.9%) cases. In five patients, minor leaks were managed conservatively (n=4) or required relaparoscopy (n=1) and placement of an additional suture (overall complication rate of 15.8%, n=8). Nutritional goals were reached after 7.8 +/- 2.3 days. Conclusion PLAG is a safe and easy procedure. It can well be used to provide enteral access for patients with pharyngoesophageal obstruction not suitable for endoscopic PEG placement.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ENDOSCOPIC GASTROSTOMY; SURGICAL GASTROSTOMY; ENTERAL NUTRITION; TRAUMA PATIENTS; TUBE PLACEMENT; PEG; HEAD; NECK; GASTROJEJUNOSTOMY; COMPLICATIONS; Enteral feeding; Feeding tube; Gastrostomy; Laparoscopic; PEG; PLAG; Percutaneous |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Jul 2020 12:48 |
| Last Modified: | 07 Jul 2020 12:48 |
| URI: | https://pred.uni-regensburg.de/id/eprint/23968 |
Actions (login required)
 |
View Item |
