First results of laparoscopic gastrostomy.
BACKGROUND
Laparoscopic gastrostomy as an alternative to open gastrostomy was introduced with various technical variants 5 years ago. However, long-term results of these new methods are still lacking.


METHODS
From 4/1993 to 2/1996, laparoscopic gastrostomies were performed on 42 patients (50.9 +/- 15.6 [24-71] years) with esophageal stenosis in locally advanced hypopharyngeal (17 patients) or oropharyngeal (nine patients) carcinoma, incurable esophageal carcinoma (13 patients) and cerebral dyspagia (three patients). Operating time was 38 +/- 11 min [15-65 min]. Procedure-related mortality was 0%. Major complications occurred in 2/42 (4.7%) patients; minor complications were found in 4/42 (9.4%) patients. During a total usage time of 427 months, 14 stoma infections occurred (0.11 infections/100 days).


CONCLUSIONS
Laparoscopic gastrostomy allows a safe, fast, and cheap reestablishment of enteral nutrition. The procedure is minimally invasive and can also be performed under local anesthesia. It has become our method of choice in patients with malignant, nonresectable subtotal stenosis of the hypopharynx or esophagus.
Peitgen
K
K
Department of General Surgery, University of Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
Walz
M K
MK
Krause
U
U
Eigler
F W
FW
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001932:Brain Neoplasms / Q000150:complications; D017024:Chemotherapy, Adjuvant; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004386:Duodenum / Q000601:surgery; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000150:complications / Q000175:diagnosis; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000150:complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008581:Meningitis / Q000150:complications; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors