Accesos enterales por endoscopia: Artículo de revisión

F. Ávila, José Froylán Rodríguez Sánchez
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引用次数: 1

Abstract

A benefit of enteral nutritional support over the parenteral for acute and chronic diseases has been observed because it is more physiological and is associated with fewer complications. The most frequently used for this purpose are nasoenterals feeding tubes lasting no more than 30 days and percutaneous accesses involving longterm feeding. Prepiloric feeding is appropriate for most critical patients. However, postpiloric feeding, which is achieved with nasojejunal probes, percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) and jejunostomy is indicated for those with regurgitation, aspiration of gastric foods or presence of leaks in the upper tractodigestive. There are several methods for the placement of enteral accesses, the endoscopic being the first choice in most cases, leaving the one performed by radiointervention and surgical for the technically difficult cases. There are advances with new endoscopic techniques such as endoscopic percutaneous jejunostomy by double balloon enteroscopy (PEJ) and endoscopic ultrasound in pacemakers with modified anatomy (Y-Roux) and excluded stomach, as well as the placement of selfexpanding metal prostheses at the duodenal or gastrojejunostomy by endoscopic ultrasound assisted by fluoroscopy guided by double balloon intestinal occlusion in cases of obstruction to the outflow tract by neoplasia. Due to the above, based on patient characteristics and prognosis, there are already more endoscopic options to preserve the enteral route as the main nutritional route in patients with chronic diseases.
内窥镜肠内通路:综述文章
对于急性和慢性疾病,肠内营养支持优于肠外营养支持,因为它更符合生理性,并发症更少。最常用于此目的的是持续不超过30天的鼻肠内喂养管和涉及长期喂养的经皮通路。对于大多数危重病人,闭锁前喂养是合适的。然而,对于那些有反流、胃食物误吸或上消化道存在渗漏的患者,可以使用鼻空肠探针、经皮内镜下空肠延伸胃造口术(PEG-J)和空肠造口术来实现尿后喂养。肠内通路的放置有几种方法,内镜下放置是大多数情况下的首选,对于技术困难的情况则采用放射干预和手术。在改良解剖(Y-Roux)排除胃的起搏器中应用双气囊小肠镜(PEJ)经皮内镜下空肠造口术和超声内镜下经皮空肠造口术等新的内镜技术取得了进展,在肿瘤阻塞流道的情况下,在十二指肠放置自膨胀金属假体或在超声内镜下辅助双气囊肠封堵下进行胃空肠造口术。正因为如此,基于患者的特点和预后,已经有更多的内镜选择来保留肠内途径作为慢性疾病患者的主要营养途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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