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A 3-step gradual dilation method: a new safe technique of percutaneous endoscopic gastrostomy for obstructive esophageal cancer.

Authors :
Takeshita N
Uesato M
Shuto K
Shiratori T
Kono T
Akutsu Y
Hoshino I
Horibe D
Narushima K
Imanishi S
Maruyama T
Semba Y
Toyozumi T
Matsubara H
Source :
Surgical laparoscopy, endoscopy & percutaneous techniques [Surg Laparosc Endosc Percutan Tech] 2014 Aug; Vol. 24 (4), pp. e140-2.
Publication Year :
2014

Abstract

Although percutaneous endoscopic gastrostomy (PEG) is the preferred method to provide enteral nutrition for a longer time period, in obstructive esophageal cancer, we cannot safely perform endoscopic access to the stomach even with the ultrathin endoscope. We experienced 1 fatal case due to esophageal perforation caused by balloon dilation, and hence, we developed a safer method. We treated 4 patients with obstructive esophageal cancer using a 3-step gradual dilation method with nasogastric tubes (from 8 to 16 Fr). After about 2 weeks of initial dilation, we could safely perform endoscopic access to the stomach with the ultrathin endoscope and PEG placement using the introducer technique. The 3-step gradual dilation method is a safe and easy procedure for endoscopic access to the stomach. It can be used to provide enteral access as a palliative treatment for patients with obstructive esophageal cancer that is not suitable for conventional PEG placement.

Details

Language :
English
ISSN :
1534-4908
Volume :
24
Issue :
4
Database :
MEDLINE
Journal :
Surgical laparoscopy, endoscopy & percutaneous techniques
Publication Type :
Academic Journal
Accession number :
25077644
Full Text :
https://doi.org/10.1097/SLE.0b013e31828fa056