tube gastrostomy

Tubular gastrostomy is a commonly used permanent gastrostomy. It uses a anterior wall of the stomach to make a tube, which is passed out of the body and perfused. Treating diseases: esophageal cancer Indication 1. Esophageal cancer can not be surgically removed, can be used as a symptom relief surgery. It is estimated that the survival period is longer than 3 months, and permanent gastrostomy may be feasible; if the survival time is shorter than 3 months, temporary gastrostomy is performed. 2. In patients with benign esophageal stricture, temporary gastrostomy may be performed as a preparatory operation to facilitate subsequent thorough surgery or dilatation treatment. 3. Some patients with special abdominal surgery, postoperative temporary gastrostomy, early decompression, can be used later to feed, help patients recover. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation Patients with esophageal obstruction can not eat for a long time before surgery. They are often malnourished. They must be fully infused and transfused to correct dehydration and anemia, improve nutrition, enhance tolerance to surgery and ensure wound healing. Surgical procedure 1. The patient is supine: generally use the left upper transabdominal rectus incision, about 6 ~ 8cm long. The upper mid-abdominal incision can also be used, and the ostomy tube can be extracted from the side of the lateral abdominal wall. 2. Do stomach wall flap: Make a sacral flap between the large and small bends in the middle of the stomach, 5cm wide and 7cm long. The base of the valve should be made on the near-bending side to ensure blood flow to the valve and to facilitate access to the outside of the body. The muscle layer is first cut; the submucosal blood vessels are sutured to stop bleeding, and then the mucosa is cut open to absorb the stomach contents. 3. Suture the stomach wall incision: open the wall flap to the large curved side, starting from the midpoint of the top of the notch of the stomach, and suturing the incision of the stomach wall with the entire layer of the 4th wire. 4. Make a "stomach tube": insert a F18 tube into the stomach cavity 5 ~ 7cm, suture the gastric wall flap margin along the entire layer of the catheter, and add a layer of pulp muscle layer intermittent suture to complete the stomach wall pedicle "stomach tube ". 5. Lead out the "stomach tube": on the outer edge of the left rectus abdominis, a small mouth is placed on the abdominal wall under the assist margin, and its position is preferably higher than the base of the "stomach tube" to avoid the overflow of the stomach contents. The "stomach tube" is taken out through a small mouth, and the stump should be exposed to the skin 0.5cm, and the wall of the tube and the surrounding peritoneum, fascia and skin are sutured with a number of needles. Finally, the abdominal wall incision is sutured. complication Gastrointestinal discomfort.

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