PubMed · 9171608
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S A Jones, P Guenter. 1997. Automatic flush feeding pumps.. https://doi.org/10.1097/00152193-199702000-00022
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Recent economic changes in health care delivery have led to more frequent feeding by tube enterostomy. Over the last two decades percutaneous endoscopic gastrostomy (PEG) has been established as the standard method for long-term enteral access for nutrition, though operative gastrostomy remains indicated in a few conditions. Additionally, the combined gastrojejunostomy tube is indicated in selected patients in need of concomitant access to the jejunum and gastric decompression. This report reviews data regarding the safety and efficacy of the PEG tube and the indications for operative gastrostomy. Complications of feeding tubes and strategies to avoid or remedy them are also discussed. More recent techniques, including laparoscopic gastrostomy and jejunal access via the stomach, are reviewed as are some ethical concerns regarding the appropriateness of feeding enterostomies in certain patients.
Surgical centers that treat esophageal cancer need to create a simple and easy method to feed patients who suffer from complete occlusion of the upper alimentary tract. The purpose of this work is to present our own modification of a laparoscopic feeding gastrostomy, which is based on our own experience and previously published methods. Our system requires only two trocars and can be done under general or local anesthesia. It consists of exteriorizing a stomach fragment through a 12-mm opening in the skin under video control. The newly created gastrostomy forms a channel in the abdominal wall that is long narrow and enough to allow a 24-F catheter to be inserted without serious leakage. The method was applied satisfactorily to 11 patients, with a mean observation time of 3.5 months. It offers the patient an ongoing nutrition gastrostomy for early use. After 3 weeks, the gastrostomy can be used on a temporary basis by inserting the catheter during the feeding time and afterward withdrawing it with the gauze pad still attached. We have found this procedure to be a simple, easy, and cost-effective alternative to supplying nutrition to patients with complete upper alimentary tract stenosis. Moreover, it is superior to previously described methods.
This report describes a newborn infant girl who presented with abdominal distension and pneumoperitoneum. At operation, near total necrosis of the stomach was observed. The esophagus was ligated, the stomach resected. The baby was fed by an transpyloric feeding tube. At 8 weeks, an esophagojejunal anastomosis was performed with a Hunt-Lawrence Pouch. A good outcome was achieved.