Transnasal ultrathin endoscopy for placement of a long intestinal tube in patients with intestinal obstruction - 23/08/11
Reprint requests: Jiro Watari, MD, Division of Endoscopy, Asahikawa Medical College Hospital, 2-1-1-1 Midorigaoka-Higashi, Asahikawa 078-8510, Japan.Asahikawa, Japan
Abstract |
Background |
The technical difficulties related to the insertion of a long intestinal tube into the jejunum under fluoroscopy present a considerable problem in patients with an intestinal obstruction.
Objective |
To evaluate the usefulness of endoscopic long intestinal-tube placement with the ultrathin esophagogastroduodenoscope (UT-EGD).
Design |
A prospective randomized clinical trial was conducted.
Patients |
Twenty-eight consecutive patients who presented with an intestinal obstruction were included in the study.
Intervention |
The UT-EGD was inserted nasally into at least the second portion of the duodenum or beyond. After a guidewire was introduced through the working channel, with fluoroscopic guidance, the UT-EGD itself was carefully removed with the guidewire left in place. Next, a hydrophilic intestinal tube was advanced over the guidewire into the jejunum, and then the guidewire was removed.
Main Outcome Measurements |
Primary end points are the total procedure time, the radiation exposure time, and the rate of complications, all compared with the conventional method.
Results |
The mean (±SD) total procedure time was 18.7 ± 8.4 minutes for the UT-EGD method and 39.5 ± 15.0 minutes for the conventional method, with a significant time difference between the 2 methods (P < .0005). The mean (±SD) radiation exposure time was also shorter with the UT-EGD method (11.1 ± 6.0 minutes) than with the conventional method (30.3 ± 13.7 minutes) (P < .0005). There were no complications, except for mild nasal bleeding with each method.
Conclusions |
The UT-EGD method has definite advantages in the placement of a long intestinal tube for patients with an intestinal obstruction in comparison with the conventional method.
Le texte complet de cet article est disponible en PDF.Abbreviation : UT-EGD
Plan
| Presented at the annual meeting of the American Society for Gastrointestinal Endoscopy, May 19-23, 2007, Washington, DC (Gastrointest Endosc 2007;65:AB280). |
Vol 67 - N° 6
P. 953-957 - mai 2008 Retour au numéro
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