[Morphologic changes of the lesser gastric curvature after segmental gastrectomy associated to proximal gastric vagotomy. Experimental study in dogs].

UNLABELLED

The segmental gastrectomy of the body of the stomach, combined with proximal gastric vagotomy, has been indicated in the treatment of duodenal ulcer, especially in patients with major risk of the recurrent ulceration.

PURPOSE

To evaluate the histopathologic changes, secondaries to combined corporeal segmental gastrectomy and proximal gastric vagotomy, in the lesser curvature of the stomach.

METHODS

Thirty-six adult mongrel dogs weighing between 10 to 20 kg were divided into three groups of twelve animals each: Group I animals (control) were submitted to laparotomy and gastric manipulation; Group II, animals underwent proximal gastric vagotomy; and Group III, animals underwent corporeal segmental gastrectomy combined with proximal gastric vagotomy. Each group was subdivided into two subgroups of six animals each, and according to the subgroup, the animals were then sacrificed on the third or in the eighth postoperative day. A fragment of the lesser curvature was removed from each stomach for microscopic study.

RESULTS

Regarding edema, vascular congestion, inflammatory exudate, fibrosis and cell damage; histopathologic changes found in animals sacrificed in the same postoperative day were slight in Group I, moderate in Group II and intense in the group III. Although nonspecific, the character and site of the lesions were similar to the ones occurring in ischemic process. It was also observed a directly proportional relation between severity of morphologic changes and ischemic potentiality of surgical procedure.

CONCLUSION

The segmental gastrectomy probably aggravated the arterial blood supply of the remnant of lesser curvature of the stomach, which was already compromised by devascularization consequent to proximal gastric vagotomy.