Setlacec D, Popovici A, Medianu D, Horvat T
Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1981 Sep-Oct;30(5):351-64.
A total of 96 patients have been hospitalized over a period of 20 years, of which 89 had been operated for recidivating post-operative ulcer (RPOU). Particular clinical and etiopathogenic aspects are stressed, such as RPOU manifested exclusively by digestive haemorrhage, pseudo-tumoral RPOU, ulcers recidivating after exclusion resection, and multi-recidivating ulcers. Prophylaxis of RPOU is best achieved by a correct primary intervention for ulcers, and the prophylaxis of the recidives should be achieved by a correct re-intervention. This presumes that a correct resection, or a correct iterative resection should be performed, as well as a correct sub-diaphragmatic vagotomy. In recidivating post-operative ulcers on the duodenal stump an important element is the insufficiency of the resection on theright, and the value is stressed of an extended resection of the stump, associated to vagotomy. In multi-recidivating ulcers after repeated interventions that have been correctly performed, gastrectomy of the total type is considered the best solution.
在20年的时间里,共有96例患者住院,其中89例因复发性术后溃疡(RPOU)接受了手术。文中强调了一些特殊的临床和病因学方面,如仅表现为消化道出血的RPOU、假性肿瘤性RPOU、排除性切除术后复发的溃疡以及多次复发性溃疡。预防RPOU最好通过对溃疡进行正确的初次干预来实现,而复发性溃疡的预防则应通过正确的再次干预来实现。这意味着应进行正确的切除或正确的反复切除,以及正确的膈下迷走神经切断术。在十二指肠残端复发性术后溃疡中,右侧切除不足是一个重要因素,文中强调了扩大残端切除并结合迷走神经切断术的价值。对于经过正确反复干预后的多次复发性溃疡,全胃切除术被认为是最佳解决方案。