Ivashkin V T, Kalinin A V, Minasian G A
Ter Arkh. 1990;62(2):129-34.
Over 5 years the authors followed up 320 patients with gastric ulcer receiving conservative treatment at hospitals or as outpatients, 86 patients operated on before for gastric ulcer, and 58 patients admitted to the surgical hospital for hemorrhage from gastric ulcer. The primary ulcerous form of carcinoma accounted for 9.1% of all gastric ulcers, carcinoma of the gastric stump was diagnosed in 10.4% of patients subjected to resection of the stomach for assumed malignant ulcer. The conservative treatment carried out at hospitals or as outpatients ensured healing of gastric ulcer within a month in 61.8 and 55.1% of the patients, respectively. Nevertheless early relapses (a month after the healing) were recorded in the appropriate groups in 26.4 and 14.9% of the patients. Among gastric ulcer patients followed up for 5 years and receiving the conservative treatment, perforation was recorded in 2.6% and hemorrhage in 4.5% of the patients. The lethality due to resection of the stomach in patients with assumed malignant gastric ulcer amounted to 4-7%. It is evident that there are no serious reasons for supporting the positions of high surgical activity champions in gastric ulcer.
在5年多的时间里，作者对320例在医院接受保守治疗或门诊治疗的胃溃疡患者、86例既往接受过胃溃疡手术的患者以及58例因胃溃疡出血而入住外科医院的患者进行了随访。原发性溃疡型癌占所有胃溃疡的9.1%，在因假定为恶性溃疡而接受胃切除手术的患者中，残胃癌的诊断率为10.4%。在医院或门诊进行的保守治疗分别使61.8%和55.1%的患者在1个月内治愈胃溃疡。然而，在相应组中，分别有26.4%和14.9%的患者出现早期复发（愈合后1个月）。在接受保守治疗并随访5年的胃溃疡患者中，穿孔发生率为2.6%，出血发生率为4.5%。假定为恶性胃溃疡患者因胃切除导致的死亡率为4%至7%。显然，没有充分理由支持胃溃疡高手术治疗率倡导者的观点。
