Stegemann B
Fortschr Med. 1982 Apr 8;100(13):586-91.
The risk of carcinoma in the stomach after non resecting surgery is not yet clear, because 12 to 14 years of clinical follow ups after vagotomy and especially selective proximal vagotomy are not long enough. Our experimental long term studies showed for the first time carcinoma in animals after vagotomy without application of a carcinogen. Due to the the operation and probably to carcinogenesis are atrophy of the mucosa, achlorhydria and ulcer as well as duodeno-gastric-reflux after drainage-operation and the lesion by the operation itself, in different and varying extents. Observing the cautious reservations needed for transferring experimental results to human conditions, vagotomy is no longer an operation out of competition compared with gastric resections, especially when a drainage-operation must be done. Careful postoperative and clinical surveillance including endoscopy and biopsy after vagotomy is necessary after resections of the stomach.
非切除手术后胃癌的风险尚不清楚,因为迷走神经切断术尤其是选择性近端迷走神经切断术后12至14年的临床随访时间不够长。我们的长期实验研究首次表明,在未使用致癌物的情况下,动物在迷走神经切断术后会发生癌变。由于手术以及可能的致癌作用,黏膜萎缩、胃酸缺乏和溃疡以及引流手术后的十二指肠-胃反流和手术本身造成的损伤,程度各不相同。考虑到将实验结果应用于人体情况时需要谨慎保留,与胃切除术相比,迷走神经切断术不再是一种无可竞争的手术,尤其是在必须进行引流手术时。胃切除术后,迷走神经切断术后进行仔细的术后和临床监测,包括内镜检查和活检是必要的。