用于胃造瘘管部位翻修的部位楔形切除技术：病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports Pub Date : 2024-06-06 DOI:10.1016/j.epsc.2024.102835

Katherine C. Bergus , Shruthi Srinivas , Peter C. Minneci

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引用次数: 0

摘要

导言胃造口术管肥大肉芽组织发展、脱垂和渗漏是常见问题，通常通过胃造口术管重新定位来治疗。楔形胃造瘘管部位切除术是一种翻修技术，用于在切除受影响组织的同时继续使用原来的造瘘管部位。本研究旨在描述这种技术以及一系列需要这种干预的患者的治疗效果。楔形胃造瘘管部位切除术包括楔形切除胃粘膜过度增生组织或脱垂的胃组织，并对剩余的缺损进行初次闭合。我们回顾了两名因药物难治性增生肉芽组织而接受楔形胃造口术的患儿的治疗结果。病例 1 的患者接受了两次胃造口术，间隔时间为两年，术后 9 个月无症状。在病例 2 中，患者只需进行一次胃造口术，13 个月来已无症状。结论楔形胃造瘘管部位切除术是一种有效的策略，可去除导致胃造瘘管周围渗漏的反应性组织，并避免胃造瘘管重新置入的发病率。

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Site wedge resection technique for gastrostomy tube site revision: A case series

Introduction

Gastrostomy tube hypertrophic granulation tissue development, prolapse, and leakage are common problems that are often treated with tube re-siting. Wedge gastrostomy tube site resection is a revision technique used to enable continued use of the original tube site while removing affected tissue. The aim of this study was to describe this technique and outcomes in a series of patients requiring this intervention. The wedge gastrostomy tube site resection involves wedge excision of hypergranulation tissue or prolapsed gastric tissue and primary closure of the remaining defect. We reviewed outcomes for two children who underwent wedge gastrostomy tube site resection for medically refractory hypergranulation tissue.

Case presentation

Two patients presented with hypertrophic granulation tissue at their gastrostomy tube sites. In Case 1, the patient underwent two revisions spaced two years apart and has been symptom-free for 9 months. In Case 2, the patient required a single revision and has been symptom-free for 13 months. Neither patient had complications related to their gastrostomy tube site revision in the immediate postoperative period.

Conclusion

Wedge gastrostomy tube site resection is a useful strategy to remove reactive tissue that contributes to leakage around a gastrostomy tube and avoids the morbidities of tube re-siting.