Rzaev N M, Seidov V D, Rustamov E A
Khirurgiia (Mosk). 1993 Sep(9):62-7.
The authors analyse the causes of 170 (38.3%) complications which occurred after 435 interventions for selective proximal vagotomy (SPV) with or without a stomach-draining operation. Specific complications were encountered in 31.9% and unspecific complications in 7.0% of cases. Intraoperative complications happened in 6 (3.6%) patients who had complications after vagotomy, early complications--in 54 (31.5%), and late complications--in 79 (46.8%) patients. The main causes of the specific complications were technical faults in performing SPV, disorder of gastric secretory, motor-evacuation, and barrier activity due to incomplete, inadequate vagotomy. Inadequate drainage and disorders of the immune system and dietary regimen, gastroduodenal reflux are conducive to the development of complications after SPV. Reconstructive-restorative operations and resection of the stomach are the operations of choice in organic complications after SPV and produce good late-term results.
作者分析了435例选择性近端迷走神经切断术(SPV)(无论是否行胃引流手术)后发生的170例(38.3%)并发症的原因。31.9%的病例出现特定并发症,7.0%的病例出现非特定并发症。迷走神经切断术后有并发症的患者中,6例(3.6%)发生术中并发症,54例(31.5%)发生早期并发症,79例(46.8%)发生晚期并发症。特定并发症的主要原因是SPV操作中的技术失误、由于迷走神经切断不完全或不充分导致的胃分泌、运动排空及屏障功能紊乱。引流不充分、免疫系统和饮食方案紊乱、胃十二指肠反流有利于SPV术后并发症的发生。重建修复手术和胃切除术是SPV术后器质性并发症的首选手术,且远期效果良好。