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[胃和十二指肠溃疡手术治疗后的晚期再次干预]

[Late reinterventions after the surgical treatment of gastric and duodenal ulcer].

作者信息

Duca S, Chirileanu T, Acalovschi I, Vlad L E, Funariu G, Părăian I, Popa E L, Kovacs T, Iancu C, Pop F

机构信息

Clinica de chirurgie III, I.M.F. Cluj-Napoca.

出版信息

Chirurgia (Bucur). 1992;41(1):19-31.

PMID:1361382
Abstract

A number of 87 reinterventions performed during a 5-year-period for late complications of the gastric and duodenal ulcer surgery are analysed. In most of them (64 cases), the cause of the reintervention was a postoperative ulcer. A long afferent loop (6 cases), the dumping syndrome (4 cases), the stenosis of the anastomosis opening (6 cases) and the primitive neoplasm of the gastric stump (7 cases) represented other causes of reintervention. The immediate postoperative results were very good and good in 69 cases. The risks related to the specific character of this surgery materialized themselves in 14 postoperative complications (anastomotic fistulas, haemorrhages from the anastomosis, stress ulcers etc.), which required iterative operations; the postoperative death rate attained 3.4%. The analysis of these postgastrectomy syndromes is an opportunity to discuss about the failure factors in the surgery of the gastric and duodenal ulcer, the possibilities of exploration and the principles which should guide the reparative therapy.

摘要

对5年间因胃和十二指肠溃疡手术晚期并发症而进行的87次再次干预进行了分析。其中大多数(64例)再次干预的原因是术后溃疡。长输入袢(6例)、倾倒综合征(4例)、吻合口狭窄(6例)和胃残端原发性肿瘤(7例)是再次干预的其他原因。术后即刻结果在69例中为非常好和良好。与该手术特殊性质相关的风险在14例术后并发症(吻合口瘘、吻合口出血、应激性溃疡等)中显现出来,这些并发症需要反复手术;术后死亡率达到3.4%。对这些胃切除术后综合征的分析为讨论胃和十二指肠溃疡手术中的失败因素、探查可能性以及指导修复治疗的原则提供了契机。

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