tunnel gastrostomy

Tunneling gastrostomy (Witzal) is mainly used for patients with esophageal cancer who cannot be surgically removed. It can be used as a symptom-reducing operation. 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. For patients with benign esophageal stricture, temporary gastrostomy may be performed as a preparatory procedure for subsequent thorough or dilated surgery. There are also some special patients with major abdominal surgery, postoperative temporary gastrostomy, early decompression, can be used later to feed, help patients recover. Treatment of diseases: congenital esophageal stricture 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. 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 Tunnel gastrostomy is also a temporary gastrostomy, with a "pump-type gastrostomy". Gastric fistula should be selected on the side of the pylorus. First, a layer of purse suture is made on the stomach wall, the stomach wall is cut at the center of the purse suture, and a common tube of F20-24 is inserted, and the head end is deep into the stomach cavity by 3 to 5 cm, and the purse string is contracted. A row of sutures along the long axis of the musculocutaneous suture (Lembert) is then sutured, and the muscle wall of the gastric wall is inverted to form a sneak tunnel about 5 cm long, and the catheter is embedded. A small hole is made in the side of the abdominal wall to lead the catheter end, and a needle is sutured between the upper and lower stomach wall of the catheter and the upper and lower peritoneum of the puncture hole, so that the stomach wall is fixed on the peritoneum of the parietal layer. Then, the abdominal wall incision is sutured layer by layer.

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