当院における腹腔鏡補助下経皮内視鏡的胃瘻造設術の経験

Experience of laparoscopically-assisted percutaneous endoscopic gastrostomy in our hospital

◆要旨：本邦では長期にわたる経腸栄養管理において，経皮内視鏡的胃瘻造設術（PEG）が選択されることが多いが，解剖学的な問題などから施行困難な症例も存在する．PEGが施行困難であった6例に，腹腔鏡補助下経皮内視鏡的胃瘻造設術（LAPEG）を施行し，その手術成績を検討し，他の外科的胃瘻造設術との比較について文献的に考察した．全身麻酔下に施行し，年齢77.5歳（31〜81），性別（男：女）6：0，手術時間は32.5分（26〜54），術後合併症は認めなかった．PEG施行困難症例に対するLAPEGは，外科的な胃瘻造設術の選択肢の一つである．

　Percutaneous endoscopic gastrostomy （PEG） is widely utilized forproviding long-term nutritional support. However, difficulties arise in patients with challenging anatomy. We performed laparoscopically assisted percutaneous endoscopic gastrostomy （LAPEG） in 6 patients in whom PEG was difficult and examined the surgical outcomes, with a comparative review of other surgical procedures for gastrostomy in the literature. The procedures were performed under general anesthesia. All patients were male, with a mean age of 70.3 years. The mean operation time was 36.3 minutes. LAPEG was safely performed in all cases. The results show that LAPEG may be a suitable surgical option if PEG is difficult to perform.