Herbst F, Gruber E, Pratschner T, Schiessel R
I. Chirurgische Universitätsklinik, Wien.
Langenbecks Arch Chir. 1992;377(5):262-6. doi: 10.1007/BF00189470.
This study reports the long-term results of 216 patients after highly selective vagotomy (HSV) for duodenal ulcers operated from 1970 through 1978 with a mean follow-up of 12.8 years (8.3-15). 26 patients developed symptomatic ulcer recurrences (12%) within 4 to 135 months following surgery, the cumulative recurrence rate (Kaplan-Meier) at 13 years was 20.3%. Acidity analyses showed a postoperative mean reduction of basal acid output (BAO) and maximal acid output (MAO) values of 80.7% and 74.8% respectively with no differences according to recurrences. The risk of recurrence was similar for duodenal (22/194) and pyloric ulcers (4/22) and no differences were found with respect to sex, additional drainage procedure, smoking habits, acute or elective operation and first or recurrent ulcers. Risk was slightly higher for complicated ulcers (p less than or equal to 0.07), but without reaching statistical significance. 78.5% of patients showed (very) good results (Visick I or II), only 6% were Visick III. HSV is therefore regarded as a valuable therapeutic measure for the treatment of duodenal ulcer independent of patient compliance.
本研究报告了1970年至1978年期间接受高选择性迷走神经切断术（HSV）治疗十二指肠溃疡的216例患者的长期结果，平均随访12.8年（8.3 - 15年）。26例患者在术后4至135个月出现症状性溃疡复发（12%），13年时的累积复发率（Kaplan-Meier法）为20.3%。酸度分析显示，术后基础酸排出量（BAO）和最大酸排出量（MAO）均值分别降低了80.7%和74.8%，复发情况无差异。十二指肠溃疡（22/194）和幽门溃疡（4/22）的复发风险相似，在性别、是否进行额外引流手术、吸烟习惯、急诊或择期手术以及初发或复发性溃疡方面未发现差异。复杂溃疡的复发风险略高（p≤0.07），但未达到统计学意义。78.5%的患者显示（非常）良好的结果（Visick I或II级），只有6%为Visick III级。因此，无论患者依从性如何，HSV都被视为治疗十二指肠溃疡的一种有价值的治疗措施。
