В мире научных открытий (Jul 2018)

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH ULTRASONIC NAVIGATION AS A METHOD OF CHOICE TO PROVIDE ENTERAL NUTRITION IN PATIENTS WITH CHRONIC CRITICAL CONDITION

  • Alexandra Vitalievna Yakovleva,
  • Alexander Anatolevich Sibak,
  • Artem Evgenievich Skvortsov,
  • Alexey Aleksandrovich Yakovlev,
  • Kirill Yurievich Krylov,
  • Marina Vladimirovna Petrova,
  • Inessa Gennadiyevna Shchelkunova,
  • Andrey Vyacheslavovich Grechko

DOI
https://doi.org/10.12731/wsd-2018-3-148-161
Journal volume & issue
Vol. 10, no. 3
pp. 148 – 161

Abstract

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Background. Analysis of the effectiveness of ULTRASOUND navigation in case of percutaneous endoscopic gastrostomy to improve the security method of ensuring the delivery of enteral nutrition. Materials and methods. Percutaneous endoscopic gastrostomy with the technique «pull», supplemented by ULTRASOUND navigation, was performed in 115 patients with the consequences of severe craniocerebral trauma and cerebral strokes, who are in a chronic critical condition and have persistent dysphagia during their rehabilitation. Results. All patients underwent surgery satisfactorily and in a day could receive enteral nutrition. In two patients (1.7%) there was a complication in the form of pneumoperitoneum, which required additional antibacterial therapy and was successfully resolved after 7–10 days, without additional surgical interventions. Adding to the ultrasound technique the area defined by diaphanoscope, proved to be effective in 15 cases (13,0%) of them with a frequency of 73,0% in particular for puncturing points of the detected liver edge, and a rate of 27,0% revealed transverse colon. Conclusion. 1. Percutaneous endoscopic gastrostomy with the technique «pull», supplemented by ULTRASOUND navigation, is an adequate way to ensure the path of enteral nutrition in patients in long-term (chronic) critical condition. 2. Carrying out the ULTRASOUND navigation of the area determined by diafanoscopy immediately before the puncture of the stomach, especially in patients with hepatomegaly, overweight and in patients with a history of surgical interventions in the abdominal cavity, allowed to avoid postoperative severe complications in 13% of cases, which proves the feasibility of the study, as part of percutaneous endoscopic gastrostomy. 3. Performing the percutaneous endoscopic gastrostomy under the ULTRASOUND navigation, it was possible to reduce the number of complications.

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