Lubianskiĭ V G, Leont'ev S V, Kuznetsov G L
Khirurgiia (Mosk). 2002(4):40-3.
Causes of unsatisfactory outcomes of pylorus preserving stomach resection are analyzed, method of prophylaxis and surgical correction is proposed. Pylorus preserving stomach resection was performed in 207 patients with chronic gastric ulcer. 2 groups of patients were compared: 166 patients who have undergone pylorus preserving stomach resection by Maky--Gorobashko (group 1); 41 patients operated according to an original method of suprapyloric stomach resection with preserving of distal Latarget nerves on serous-muscular flap formed from lesser curvature of the stomach (group 2). Of 122 examined patients of group 1 excellent and good long-term results according to Visick's criteria were achieved in 101 (82.79%), satisfactory--in 12 (9.84%), unsatisfactory--in 9 (7.37%). Bad stump evacuation due to a stable spasm of the denervated pylorus and hypokinesia of the stump were the main causes of unsatisfactory results. In group 2-39 of 41 patients were examined in long-term period. Excellent and good results were achieved in 38 patients, satisfactory--in 1. There were no unsatisfactory results.
分析了保留幽门胃切除术效果不理想的原因，提出了预防和手术矫正方法。对207例慢性胃溃疡患者实施了保留幽门胃切除术。比较了两组患者：166例采用马基-戈罗巴什科法行保留幽门胃切除术的患者（第1组）；41例按照胃幽门上切除术的原始方法进行手术，保留由胃小弯形成的浆肌瓣上的远端拉塔热神经的患者（第2组）。在第1组的122例接受检查的患者中，根据维西克标准，101例（82.79%）获得了优秀和良好的长期效果，12例（9.84%）为满意，9例（7.37%）为不满意。去神经支配的幽门持续痉挛导致残端排空不良以及残端运动功能减退是效果不理想的主要原因。在第2组中，41例患者中有39例接受了长期检查。38例患者取得了优秀和良好的效果，1例为满意。没有不满意的结果。
