urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2023-22-1-127-135urmj-1202Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsФакторы риска неблагоприятного исхода чрескожной эндоскопической гастростомииRisk factors for adverse outcomes of percutaneous endoscopic gastrostomyhttps://orcid.org/0000-0001-9636-3807ЖариковЮ. О.ZharikovYu. O.

Юрий Олегович Жариков – кандидат медицинских наук 

Москва

Yurij O. Zharikov – Ph.D. in medicine 

Moscow

dr_zharikov@mail.ruhttps://orcid.org/0000-0003-4240-2449ГурциевМ. Х.GurtsievM. Kh.

Марат Хасанбекович Гурциев – врач-эндоскопист 

Москва

Marat Kh. Gurtsiev – Endoscopist 

Moscow

mgurtsiev@yandex.ruhttps://orcid.org/0000-0003-2558-2732СамсоноваМ. Д.SamsonovaM. D.

Мария Дмитриевна Самсонова – студентка 

Москва

Marija D. Samsonova – Student 

Moscow

samsonovamd99@gmail.comhttps://orcid.org/0000-0002-4621-6689Тер-АкопянК. А.Ter-AkopyanK. A.

Карен Арменович Тер-Акопян – студент 

Москва

Karen A. Ter-Akopyan – Student 

Moscow

terkaren@mail.ruhttps://orcid.org/0000-0003-1270-5414ЯрцевП. А.YartsevP. A.

Петр Андреевич Ярцев – доктор медицинских наук 

Москва;Пенза

Petr A. Yartsev – Doctor of Science (Medicine) 

Moscow;Penza

peter-yartsev@yandex.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет)РоссияSechenov First Moscow State Medical UniversityRussian FederationНаучно-исследовательский институт скорой помощи имени Н.В. Склифосовского ДЗМРоссияN.V. Sklifosovskii Research Institute for Emergency MedicineRussian FederationНаучно-исследовательский институт скорой помощи имени Н.В. Склифосовского ДЗМ; Пензенский институт усовершенствования врачей – филиал Российской медицинской академии непрерывного профессионального образованияРоссияN.V. Sklifosovskii Research Institute for Emergency Medicine; Penza Institute of Advanced Medical Training, a branch of the Russian Medical Academy of Continuing Professional EducationRussian Federation202317032023221127135Copyright © Жариков Ю.О., Гурциев М.Х., Самсонова М.Д., Тер-Акопян К.А., Ярцев П.А., 20232023Жариков Ю.О., Гурциев М.Х., Самсонова М.Д., Тер-Акопян К.А., Ярцев П.А.Zharikov Y.O., Gurtsiev M.K., Samsonova M.D., Ter-Akopyan K.A., Yartsev P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1202

Введение. Чрескожная эндоскопическая гастростомия на сегодняшний день считается операцией выбора при необходимости длительного энтерального питания при синдроме дисфагии. Методика характеризуется незначительной частотой ранних и отдаленных осложнений вследствие малой травматичности доступа и времени операции. Цель работы – оценить предикторы риска развития осложнений чрескожной эндоскопической гастростомии и их значимости для послеоперационного периода. Материалы и методы. Проведен поиск публикаций и анализ литературных источников с использованием баз данных PubMed, MedLine и научных библиотек Cochrane Library и elibrary.ru преимущественно за последние 10 лет. Поиск осуществляли по совокупности ключевых слов: чрескожная эндоскопическая гастростомия, синдром дисфагии, послеоперационные осложнения, факторы риска. Результаты и обсуждение. Ведущими и наиболее изученными предикторами осложнений раннего и отдаленного послеоперационного периода после гастростомии являются гипоальбуминемия, некомпенсированный сахарный диабет, тромбоцитопения, повышенный уровень С-реактивного белка, индекс коморбидности Чарлсона (от 4 и выше баллов), антиагрегантная и антикоагулянтная терапия, морфо-конституциональные особенности пациентов. Заключение. Анализ данных показал, что при соблюдении критериев отбора пациентов для операции с учетом общего состояния, факторов риска и исключением абсолютных противопоказаний чрескожной эндоскопической гастростомии при высоком потоке пациентов и дополнением гастростомии гастропексией является практически безопасной и эффективной .

Introduction. Presently, percutaneous endoscopic gastrostomy is considered to be the operation of choice when long-term enteral feeding in dysphagia syndrome is required. The technique is characterized by low incidence of early and long-term complications due to low traumatic access and operation time. Aim of the work was to assess the risk predictors of percutaneous endoscopic gastrostomy complications and their significance for the postoperative period. Materials and methods. We searched publications and analyzed literature sources using PubMed and MedLine databases and Cochrane Library and elibrary.ru scientific libraries mainly for the last ten years. The search was performed using a set of key words: percutaneous endoscopic gastrostomy, dysphagia syndrome, postoperative complications, risk factors. Results and discussion. The leading and most studied predictors of early and long-term postoperative period complications after gastrostomy are hypoalbuminemia, uncompensated diabetes mellitus, thrombocytopenia, elevated levels of C-reactive protein, Charlson's comorbidity index (4 points or higher), antiaggregant and anticoagulant therapy, morphoconstitutional features of patients. Conclusion. Data analysis has shown that percutaneous endoscopic gastrostomy at high patient flow and gastropectomy supplementation with gastropexy is practically safe and effective if the selection criteria for the operation are observed taking into account the general condition, risk factors and exclusion of absolute contraindications.

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The authors declare that there are no conflicts of interest present.