Double PTEG (percutaneous trans-esophageal gastro-tubing) was useful in nutrition and decompression for a gastric cancer patient with pyloric stenosis: a case report
- Pyloric stenosis; Gastric cancer; Nutrition management; Decompression; PTEG; Double PTEG
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For gastric cancer patients with strong pyloric stenosis, decompression by nasogastric tube insertion for gastric distension and central venous nutrition management have been performed. However long-term indwelling of the nasogastric tube is accompanied by pain, and Central venous catheter placement is inferior to enteral nutrition from infection risk and nutritional viewpoint. Furthermore, these generally require management in hospitalization.
An 81-year-old male was referred to our hospital for gastric cancer accompanied by pyloric stenosis. Blood test resulted in low nutrition and anemia. CT showed thickening of the wall from the anterior gastric part to the pylorus and enlargement of 50mm in the regional lymph node, and gastric distention. We planned resection after preoperative chemotherapy. We performed double PTEG (Percutaneous Tran Esophageal Gastro-tubing) from cervical co-wound for decompression and nutrition management of the stomach. Total laparoscopic gastrectomy was performed on day 114 after insertion of the double PTEG. During which time he had been good nutrition and no gastric distention with stayed at home for 42 days. On the 10th postoperative day, he was clinically released from hospital without any complications.
We conducted a new management to reduce and nourish patients with gastric cancer who had a pyloric stenosis by double PTEG (percutaneous trans-esophageal gastro-tubing), and can perform curative surgery after preoperative chemotherapy including home management period.
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