Percutaneous endoscopic microgastrostomy as a method of the long-term enteral nutrition therapy and therapeutic treatment of patients

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Abstract


Aim. Analysis of the experience of percutaneous endoscopic microgastrostomy use for the long-term enteral nutrition therapy and therapeutic treatment of patients with Parkinson’s disease.

Methods. The group of 4-year observation period (2012-2016) included 20 patients aged 55 to 72 with severe form of Parkinson’s disease, mostly males. All patients had microgastrostomy performed in 2008-2012 with the use of «Frezenius» set. Through microgastrostomy levodopa-carbidopa was administered by microdrainage to jejunum.

Results. During the first year of functioning of gastrostomy the following complications occured: gastric juice leakage to the skin surface causing the skin maceration (in 2 cases), growth of hypergranulations around gastrostomy (in 3 cases), prolapse of the supporting ring of microgastrostomy to subcutaneous fat causing abscess (in 2 patients). By the end of the fourth year of observation 3 more patients developed prolapse of microgastrostomy to subcutaneous fat without suppuration. The authors in each certain case used different preventive methods and treatment of complications. To prevent gastric juice leakage and growth of hypergranulation, correction of tube fixation and local treatment are necessary; to prevent prolapse of the supporting ring of gastrostomy use of prolene mesh is appropriate. The microgastrostomy should be changed once in 3-4 years with proper care. When microdrainage is used for medication administration through gastrostomy to jejunum, its replacement is necessary at least once in 2 years to prevent bezoar development on catheter.

Conclusion. Puncture microgastrostomy performed under endoscopic control can be effectively used for long-term nutrient and medications administration to digestive tract.


M F Samigullin

Author for correspondence.
9363926@mail.ru
Kazan State Medical Academy; Republican Clinical Oncology Center Kazan, Russia; Kazan, Russia

I V Bilalov

9363926@mail.ru
Kazan State Medical University Kazan, Russia

E A Duglav

9363926@mail.ru
Republican Clinical Oncology Center Kazan, Russia

T V Kosolapova

9363926@mail.ru
Kazan State Medical Academy Kazan, Russia

F T Kundukhova

9363926@mail.ru
Kazan State Medical Academy Kazan, Russia

A R Khabibulina

9363926@mail.ru
Kazan State Medical Academy Kazan, Russia

  • Gauderer M.W., Ponsky J.L., Izant R.J. Gastrostomy without laparotomy: A percutaneous endoscopic technique. J. Pediatr. Surg. 1980; 15 (6): 872-875. doi: 10.1016/S0022-3468(80)80296-X.
  • Hogan R.B., DeMarco D.C., Hamilton J.K. et al. Percutaneous endoscopic gastrostomy - to push or pull: A prospective randomized trial. Gastrointest. Endosc. 1986; 32 (4): 253-258. doi: 10.1016/S0016-5107(86)71841-5.
  • Russell T.R., Brotman M., Norris F. Percutaneous gastrostomy. A new simplified and cost effective technique. Am. J. Surg. 1984; 148: 132-137. doi: 10.1016/0002-9610(84)90300-3.
  • Белевич В.Л., Струков Е.Ю., Бреднев А.О., Овчинников Д.В. Чрескожная эндоскопическая гастростомия - метод выбора для длительного энтерального питания. Novosti Khirurgii. 2014; 22 (6): 750-754. doi: 10.18484/2305-0047.2014.6.750.
  • Евреш М.А., Багина Е.А. Методика чрескожной эндоскопической гастростомии (ЧЭГ) - новая технология обеспечения доступа для энтерального питания. Интенсив. терап. 2007; (1): 20-22.
  • Харкевич Д.А. Фармакология. М.: ГЭОТАР-Медиа. 2006; 229-230.
  • Назыров Ф.Г., Садыков Р.А., Им В.М. Альтернативный метод обучения навыкам операций на желудке. Гастростомия. Методическое руководство. Ташкент: МЗРУ ТМА. 2010; 48 с.

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© 2017 Samigullin M.F., Bilalov I.V., Duglav E.A., Kosolapova T.V., Kundukhova F.T., Khabibulina A.R.

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