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Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
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Open gastrostomy by mini-laparotomy: a comparative study.

Gil R Faria1, Antonio Taveira-Gomes

  • 1Department of Surgery, Faculty of Medicine, University of Porto, Hospital S. João, General Surgery Department, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal. gilfaria@netcabo.pt

International Journal of Surgery (London, England)
|January 5, 2011
PubMed
Summary
This summary is machine-generated.

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Simplified open gastrostomy (SOG) is a safe and effective alternative for long-term nutritional support in high-risk patients with dysphagia. This technique, using local anesthesia and minimal incision, offers shorter operative times with comparable outcomes to Stamm gastrostomy.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Patient Care

Background:

  • Gastrostomy tube feeding is crucial for patients with dysphagia due to tumors or neuromuscular diseases.
  • High-risk patients often have respiratory issues, limiting general anesthesia or sedation for gastrostomy.
  • A simplified open gastrostomy (SOG) under local anesthesia is used for these compromised patients.

Purpose of the Study:

  • To compare the surgical outcomes of a simplified open gastrostomy (SOG) with the classical Stamm gastrostomy (SG).
  • To evaluate the safety and efficacy of SOG in high-risk patients.

Main Methods:

  • Retrospective analysis of 63 gastrostomies over 3 years, with 23 performed using SOG.
  • SOG involves a minimal midline incision, local anesthesia, and tube placement via a stab wound without peritoneal sutures.

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  • Stamm gastrostomy (SG) served as the comparison group.

    • Main Results:

    • SOG was predominantly used for neuromuscular diseases (p < 0.001), while SG was for oncological patients.
    • SOG patients had a higher ASA IV classification (95.4% vs 74.4%, p = 0.03).
    • SOG demonstrated a significantly shorter operative time (37 vs 60 min, p = 0.01) and exclusively used local anesthesia.
    • No significant difference in in-hospital morbidity-mortality (p = 0.18) was observed.
    • Adequate nutritional support and high patient/caregiver satisfaction were reported for both methods.

    Conclusions:

    • Simplified mini-laparotomy gastrostomy is a safe and effective alternative for gastrostomy.
    • The combination of local anesthesia, minimal surgical approach, and short operative time makes SOG effective even in high-risk individuals.
    • SOG provides a viable option for nutritional support in patients unsuitable for traditional gastrostomy procedures.