Napolitano A, Gaspari A, Badiali M
Minerva Chir. 1979 Apr 30;34(8):623-30.
The physiopathological premisses underlying vagotomy and its use in the treatment of gastroduodenal ulcer are examined. It is submitted that the inadequacies and risks of the original technique are reflected in the modifications subsequently introduced into truncular vagotomy. A long-term assessment is made of a series of patients operated for duodenal ulcer by different surgeons using different forms of vagotomy. It is felt that superselective vagotomy is most consonant with the therapeutic objectives and associated with the least risk. In addition vagotomy is indicated in subjects with POPU after gastric section whose local and general condition contraindicate more complicated and serious measures, such as degastroenterostomy with further resection.
本文探讨了迷走神经切断术的生理病理学前提及其在胃十二指肠溃疡治疗中的应用。研究表明,最初技术的不足和风险反映在随后引入的迷走神经干切断术的改良中。对一系列由不同外科医生采用不同形式的迷走神经切断术治疗十二指肠溃疡的患者进行了长期评估。研究认为,超选择性迷走神经切断术最符合治疗目标且风险最小。此外,对于胃切除术后出现胃排空延迟(POPU)且局部和全身状况不适合采取更复杂、更严重措施(如进一步切除的胃肠吻合术)的患者,也可考虑行迷走神经切断术。