Gastrostomy

Indication 1. Patients with esophageal obstruction (such as tumor or esophageal stricture) as a solution to eating problems. 2. The treatment plan is implemented by infusing the drug into the stomach tube. 3. As a gastrointestinal decompression after abdominal surgery. Contraindications Gastric fistula is generally traumatic, but can be used as a relative contraindication in the following situations: 1. Have severe heart and lung dysfunction. 2. There is a serious abdominal infection, and there may be a spread of infection in the open stomach. 3. Patients with advanced cancer have a large number of ascites unable to control. Preoperative preparation 1. Anesthesia can be performed by epidural anesthesia or general anesthesia. The former is appropriate. 2. Position and incision: use the supine position. Generally, the left upper abdomen longitudinal incision is selected. Surgical procedure 1. After routine disinfection of the skin in the surgical area, make a longitudinal incision in the left upper abdomen, cut the abdominal wall layer by layer, and enter the abdomen. In the anterior wall of the stomach, near the pylorus, choose a sacral suture, first make a purse-string suture, cut the layers of the stomach wall in the center, absorb the stomach contents, insert the transparent hose, and then ligature the purse string. 2. Make another purse-string suture around the catheter and turn the stomach wall into it. 3. The catheter is attached to the stomach wall along the longitudinal axis of the stomach wall and sutured with a thin wire for a row of muscle layers. The catheter is embedded in the stomach wall for about 5 cm to prevent the gastric contents from flowing into the abdominal cavity after extubation. 4. Make a small opening on the left side of the incision and fix it on the abdominal wall. The catheter outlet of the stomach wall should also be fixed with the peritoneum for 2 to 3 needles. 5. Slot the incision layer by layer and cover with a sterile gauze.