Della Beffa V, Carelli-Basile A, Leli R, Fontana D
Divisione di Chirurgia, USL 32, Ospedale S. Crocé, Moncalieri Torino.
Minerva Chir. 1994 Nov;49(11):1065-9.
In this study the authors want to underline the changing strategies for peptic ulcer disease. Considering the experience of two Surgery Departments in Piedmont, the G. Bosco Hospital of Turin and the S. Croce Hospital of Moncalieri, in the last 15 years, they observed a notable reduction of gastric resections owing to new drugs such as H2-antagonist and omeprazole in peptic ulcer therapy. The authors report, therefore, recent suggestions to gastric resection in the cases of complicated ulcer or not. Today pyloric stenosis due to chronic ulcer no longer operated and perforated ulcer is resected only when there is a great gastric hole, or a relapse perforation or a bleeding together to perforation. On the contrary hemorrhagic ulcer is operated when the bleeding is either notable, or relapse, or continuous, or untransfusible.
在本研究中,作者想要强调消化性溃疡疾病不断变化的治疗策略。考虑到皮埃蒙特地区两个外科科室(都灵的G. 博斯科医院和蒙卡列里的圣十字医院)过去15年的经验,他们观察到由于在消化性溃疡治疗中使用了如H2拮抗剂和奥美拉唑等新药,胃切除术显著减少。因此,作者报告了对于复杂溃疡或非复杂溃疡病例进行胃切除术的最新建议。如今,由慢性溃疡引起的幽门狭窄不再进行手术,只有在存在巨大胃穿孔、复发性穿孔或出血合并穿孔时才对穿孔性溃疡进行切除。相反,当出血显著、复发、持续或难以输血治疗时,才对出血性溃疡进行手术。