Kraft R O
Surgery. 1984 Apr;95(4):460-6.
Two hundred thirteen patients were evaluated to establish the efficacy of vagotomy and pyloroplasty in the treatment of benign gastric ulcer disease. These patients underwent operation between the years 1960 to 1973. Ten patients (5%) were found to have occult gastric malignancies and four of these patients (40%) were cured after resectional therapy. Nineteen patients underwent pyloroplasty without vagotomy, and these patients were ultimately excluded from the study in view of the frequency (26%) of ulcer recurrence. The operative mortality rate was 8.4% overall (1.5% when related to elective operations and 22% of the operative deaths following emergent procedures). Eighty-eight percent of the patients were followed until death or for a minimum of 10 years. Recurrent ulcer disease was confirmed in 11% of the patients. Severe postoperative sequelae were encountered in 3% of the patients for a total failure rate of 14% at 10 years. Recurrences and postoperative sequelae were both more common in women and in those patients who underwent operation for intractability. Vagotomy with pyloroplasty is considered an acceptable alternative operation in the management of patients with benign gastric ulcer disease. It is most applicable in the high-risk patient who requires operative intervention emergently and, in this circumstance, a decreased mortality rate can be demonstrated and ulcer recurrence is unlikely (2%).
对213例患者进行了评估，以确定迷走神经切断术和幽门成形术治疗良性胃溃疡疾病的疗效。这些患者于1960年至1973年间接受了手术。发现10例患者（5%）患有隐匿性胃恶性肿瘤，其中4例患者（40%）在接受切除治疗后治愈。19例患者仅接受了幽门成形术而未行迷走神经切断术，鉴于溃疡复发率（26%），这些患者最终被排除在研究之外。总体手术死亡率为8.4%（择期手术相关死亡率为1.5%，急诊手术后的手术死亡病例中22%）。88%的患者被随访至死亡或至少随访10年。11%的患者确诊有复发性溃疡疾病。3%的患者出现严重术后后遗症，10年时总失败率为14%。复发和术后后遗症在女性以及因顽固性溃疡接受手术的患者中更为常见。迷走神经切断术加幽门成形术被认为是治疗良性胃溃疡疾病患者的一种可接受的替代手术。它最适用于需要紧急手术干预的高危患者，在这种情况下，可以证明死亡率降低且溃疡复发可能性不大（2%）。
