Novosti
Khirurgii

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Year 2014 Vol. 22 No 6

EXCHANGE OF EXPERIENCE

V.L. BELEVICH, E.Y. STRUKOV, A.O. BREDNEV, D.V. OVCHINNIKOV

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY – THE METHOD OF CHOICE FOR LONG-TERM ENTERAL NUTRITION

FSBMEE HPE “Military Medical Academy named after S.M. Kirov”, the Ministry of Defense Russian Federation, Saint-Petersburg
The Russian Federation

Objectives. To analyze the experience of the percutaneous endoscopic gastrostomy performance in patients with different clinical pathology, to determine the indications for its application in each case, to find out the «weakest» technical points of this procedure and to warn against failures during mastering the method.
Methods. Over the period of 2007-2014 the imposition of 395 gastrostomies in patients with various disorders of swallowing and dysphagia have been carried out. The main group of 366 patients (93%) was comprised of patients with neurological status, treated in the emergency departments and intensive care units. 19 (4,8%) patients were underwent the percutaneous endoscopic gastrostomy (PEG) due to disturbance related to the esophagus integrity as a result of cancer progression and tumor lysis – 11 patients and so as a result of its injury – 8. 10 (2,2%) patients with Parkinson’s disease underwent PEG to more effective delivery of drugs to the small intestine (gastroenterostomy).
Results. This technique has been used in the case of necessity of enteral tube feeding more than 3 weeks in the absence of real positive forecast of consciousness and swallowing function recovery. The average operative time is 10-15 min. The postoperative complications were observed in 10 (2,2%) cases: peritonitis – 1, suppuration of surgical wounds – 5, pneumomediastinum – 1, bleeding – 1. Uncontrolled removal of the tube was observed in 2 cases.
Conclusion. The results of study have manifested the widespread application of endoscopic gastrostomy in clinical practice provides more proficient and reliable nutritional support of patients, improves outcomes and quality of life, reducing the number of complications. It can be considered the method of choice for the long-term enteral nutrition (more than 3 weeks) in patients with dysphagia of various geneses.

Keywords: percutaneous endoscopic gastrostomy, gastrostomy, enteral nutrition, dysphagia, feeding tube
p. 750-754 of the original issue
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Address for correspondence:
194044, Rossiyskaya Federatsiya,
g. Sankt-Peterburg, ul. Akademika Lebedeva, d. 6, FGBVOU VPO «Voenno-meditsinskaya akademiya imeni S.M. Kirova» MO RF, kafedra obschey khirurgii,
tel. 8-911-213-62-53,
e-mail: antonbrednev@rambler.ru,
Brednev Anton Olegovich
Information about the authors:
Belevich V.L. PhD, a senior instructor of the general surgery chair of FSBMEE HPE “Military Medical Academy named after S.M. Kirov”, the Ministry of Defense, Russian Federation, colonel of the medical service.
Strukov E.Y. PhD, an applicant for Doctor’s degree of the of the anesthesiology and reanimatology chair of FSBMEE HPE “Military Medical Academy named after S.M. Kirov”, the Ministry of Defense, Russian Federation, lieutenant colonel of the medical service.
Brednev A.O. An adjunct of the general surgery chair of FSBMEE HPE “Military Medical Academy named after S.M. Kirov”, the Ministry of Defense, Russian Federation senior lieutenant of the medical service.
Ovchinnikov D.V. PhD, vice head of department of organization of scientific work and training of the teaching staff) (for the preparation of scientific and scientific-pedagogical personnel) of FSBMEE HPE “Military Medical Academy named after S.M. Kirov”, the Ministry of Defense, Russian Federation, major of the medical service.
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