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Δ. Έξαρχος και συν. Διαδερμική Γαστροστομία υπό την καθοδήγηση Αξονικού Τομογράφου
γνώση της μεθόδου να εφαρμόζεται σε νοσοκομεία
όπου υπάρχει επεμβατικό τμήμα με ακτινοσκόπηση,
ή όταν δεν είναι εφικτή η τοποθέτηση γαστροστομί-
ας χειρουργικά ή ενδοσκοπικά, όπως στην πρώτη
περίπτωση που αντιμετωπίσαμε. Στον ασθενή είχε
προηγηθεί χειρουργική γαστροστομία προ 2ετίας
και λόγω συμφύσεων αποφασίστηκε η διαδερμική
τοποθέτηση στον αξονικό τομογράφο.
Η διαδερμική γαστροστομία είναι εφικτή, ασφαλής,
ανεκτή από τους ασθενείς και αποτελεσματική μέθοδος
διατροφικής υποστήριξης των ασθενών
13
.
SUMMARY
Exarhos D
1
, Matsiras I
1
, Tsoukalos G
1
, Lazarioti F
1
,
Chondros D
1
, Papadogeorgakis N
2
.
Percutaneous
gastrostomy with computed tomography guid-
ance.
Purpose:
To describe the procedure of percutaneous
gastrostomywith the guidance of computed tomography
and our experience.
Materials-Method:
CTguided gastrostomy catheters
were placed in 5 patients with a primary cancer of the
oropharynx. Three patients had a Wills-Oglesby 14F
catheter placed in the stomach and in two patients a
balloon 18F catheter was placed with the Seldinger
technique after adequate dilatations of the stomach.
Four patients had the procedure performed before
surgery and one post-operatively prior to radiotherapy.
Follow up of the patients was scheduled every two
weeks for as long as the catheters remained.
Results:
All 5 gastrostomy catheters were successfully
placed and no procedure related or late complications
were reported.
Conclusion:
Percutaneous gastrostomy with the
guidance of computed tomography is feasible, well
tolerated by the patients and is an effective way of
gastrointestinal feeding support.
Keywords:
Percutaneous gastrostomy, Computed
Tomography, Interventional radiology
1
Department of CT-MRI, Evangelismos General
Hospital, Athens, Greece
2
Department of Oromaxillary Syrgery, University
of Athens, Evangelismos General Hospital, Athens,
Greece
ΒΙΒΛΙΟΓΡΑΦΙΑ
1. Waslljew B, Ujiki G, Beal J. Feeding gastrostomy:
Complications and mortality. The Am J of Surg Feb
1982; 143(2):194-195.
2. Gauderer M, Ponsky J, Izant R. Gastrostomy without
laparotomy: a percutaneous endoscopic technique. J
Pediat Surg 1980; 15:872-875.
3. Wills JS, Oglesby JT. Percutaneous gastrostomy.
Radiology Nov 1983; 149(2):449-453.
4. GivenMF, Lyon SM, LeeMJ. The role of the intervention
radiologist in enteral alimentation. Eur Radiol Jan 2004;
14(1):38-47.
5. Deutsch LS, Kannegieter L, Vanson DT, et al. Simplified
percutaneous gastrostomy. Radiology Jul 1992; 184(1);
181-183.
6. Cope C. Suture anchor for visceral drainage. AJR Am
J Roentgenol Jan 1986; 146(1): 160-162.
7. De Baere T, Chapot R, Kuoch V, et al. Percutaneous
gastrostomy with fluoroscopic guidance: a single center
experience in 500 consecutive cancer patients. Radiology
Mar 1999; 210(3):651-654.
8. Funaki B, Zaleski GX, Lorenz J, et al. Radiologic
gastrostomy placement: pigtail versus mushroom-
retained catheters. AJR Am J Roentgenol Aug 2000;
175(2):375-379.
9. Kanterman RY, Hicks ME, Simpson KR, et al. Non
surgical management of gastric duodenal perforation
from a Wills-Ogelsby-type gastrostomy tube. J Vasc
Inter Radiol Sep-Oct 1996; 7(5):737-741.
10. Barkmeir JM, Trerotola SO, Wiebke EA, et al.
Percutaneous radiologic, surgical endoscopic
and percutaneous endoscopic gast rostomy/
gastrojejunostomy: comparative study and cost
analysis. Cardiovasc Intervent Radiol Jul-Aug 1998;
21(4):324-328.
11. De Wald Cl, Hiette PO, Sewall LE, et al. Percutaneous
gastrostomy and gastrojejunostomy with gastropexy:
experience in 70 procedures. Radiology Jun 1999;
211(3):651-656.
12. Sanchez RB, Sonnenberg E, D’Agostina H, et al.
CT guidance for percutaneous gastrostomy and
gastroenterostomy. Radiology July 1992; 184:201-
205.
13. Gottschalk A, Strotzer M, Feuerbach S. Ct guided
percutaneous gastrostomy: success rate, early and late
complications. Rofo 2007 Apr; 179(4):387-395.