Ogoshi K, Mitomi T
Department of Surgery, Tokai University, Isehara, Japan.
Nihon Geka Gakkai Zasshi. 1992 Apr;93(4):393-9.
Patients with recurrent peptic ulcer undergoing surgery were reviewed at 57 institutions by the 18th meeting of the Japanese Research Society of Gastric Surgery. The factors involved in recurrence was analyzed in patients fulfilling the following criteria: the minimum follow-up period was over 5 years, the age was over 15 years, tetragastrin-stimulated acid secretion was measured before surgery, and the recurrence was confirmed by endoscopy or upper gastrointestinal radiography. In 632 patients, the recurrence rate of duodenal ulcer was significantly higher than that of gastric ulcer. However, the duodenal ulcer patients undergoing selective vagotomy and antrectomy did not develop recurrence. A significant difference in the recurrence rate was observed between selective vagotomy and antrectomy and the wide gastrectomy or selective proximal vagotomy. By analysis using the Cox proportional hazard model, the risk factors for recurrence of duodenal ulcer were the ulcer stage, the operative procedure, the location of the ulcer, and the age of the patient. Especially, recurrences in patients receiving selective proximal vagotomy depended on the location of the ulcer and the age, but the risk factors for patients undergoing wide gastrectomy were uncertain.
日本胃癌外科学会第18次会议对57家机构中接受手术治疗的复发性消化性溃疡患者进行了回顾。对符合以下标准的患者的复发相关因素进行了分析：最短随访期超过5年，年龄超过15岁，术前测量了四肽胃泌素刺激的胃酸分泌，且通过内镜检查或上消化道造影证实复发。在632例患者中，十二指肠溃疡的复发率显著高于胃溃疡。然而，接受选择性迷走神经切断术和胃窦切除术的十二指肠溃疡患者未出现复发。选择性迷走神经切断术和胃窦切除术与广泛胃切除术或选择性近端迷走神经切断术之间的复发率存在显著差异。通过Cox比例风险模型分析，十二指肠溃疡复发的危险因素为溃疡分期、手术方式、溃疡部位和患者年龄。特别是，接受选择性近端迷走神经切断术的患者复发取决于溃疡部位和年龄，但接受广泛胃切除术患者的危险因素尚不确定。
