Ihász M, Bátorfi J, Bálint A, Fazekas T, Máté M, Pòsfai G, Sándor J
Third Department of Surgery, Semmelweis Medical University, Budapest, Hungary.
Surg Today. 1996;26(7):546-51. doi: 10.1007/BF00311565.
A retrospective analysis was conducted of 778 patients who underwent highly selective vagotomy between 1980 and 1990. Surgery was performed for duodenal ulcers without any complications in 485 (62.3%) patients; for duodenal ulcers with complications such as stenosis, bleeding, or perforation in 270 (34.7%); for combined duodenal and ventricular ulcers in 12 (1.5%), and for ventricular ulcers alone in 11 (1.4%). Pyloroplasty was additionally performed in the presence of complications only. The incidence of intraoperative complications proved to be as high as 1.4%, occurring in 11 patients, while postoperative complications developed in 247 patients (31.7%). Although the overall mortality was 0.6% (5 patients), the mortality rate of those patients who underwent surgery for uncomplicated ulcer disease was 0.2% only (2 patients). The patients comprised 554 men (71.2%) and 224 women (28.8%) with an average age of 41.4 +/- 0.7 years. The average duration of duodenal ulcer disease was 9.5 years, and 643 (83.2%) of the patients were able to be regularly followed up for between 3 and 13 years. Recurrence developed in 62 patients (9.6%): in the duodenum in 57 patients (91.9%), and in the stomach in 5 (8.1%). The rate of recurrence according to sex was 9.4% in men and 10.3% in women, being 42 and 20 patients, respectively. The average duration until recurrence appeared was 27.06 +/- 3.44 months. A reoperation proved necessary in 28 of these 62 patients (45.1%). The clinical results were evaluated by means of a modified Visick classification, according to which 81.8% of the patients belonged to groups 1 or 2, 7.9% to group 3, and 10.3% to group 4.
对1980年至1990年间接受高选择性迷走神经切断术的778例患者进行了回顾性分析。485例（62.3%）患者因无任何并发症的十二指肠溃疡接受手术；270例（34.7%）因十二指肠溃疡伴有狭窄、出血或穿孔等并发症接受手术；12例（1.5%）因十二指肠溃疡合并胃溃疡接受手术，11例（1.4%）仅因胃溃疡接受手术。仅在出现并发症时才额外进行幽门成形术。术中并发症发生率高达1.4%，11例患者出现并发症，而术后并发症发生在247例患者中（31.7%）。尽管总死亡率为0.6%（5例患者），但因无并发症溃疡病接受手术的患者死亡率仅为0.2%（2例患者）。患者包括554名男性（71.2%）和224名女性（28.8%），平均年龄为41.4±0.7岁。十二指肠溃疡病的平均病程为9.5年，643例（83.2%）患者能够接受3至13年的定期随访。62例患者（9.6%）复发：57例（91.9%）在十二指肠复发，5例（8.1%）在胃复发。按性别计算的复发率男性为9.4%，女性为10.3%，分别为42例和20例。复发出现的平均时间为27.06±3.44个月。这62例患者中有28例（45.1%）需要再次手术。临床结果采用改良的Visick分类法进行评估，据此81.8%的患者属于1组或2组，7.9%属于3组，10.3%属于4组。
