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[使用杉浦-二川手术的迷走神经切断术-幽门成形术后并发症与消化性溃疡疾病手术的比较研究]

[A comparative study of complications after vagotomy-pyloroplasty using Sugiura-Futagawa procedure and surgery of acid peptic disease].

作者信息

Orozco H, Mercado M A, Morales-Linares J C, Gómez-Méndez T J

机构信息

Clínica de Hipertensión Portal, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.

出版信息

Rev Gastroenterol Mex. 1996 Oct-Dec;61(4):356-61.

PMID:9072789
Abstract

BACKGROUND

The frequency of complications of vagotomy and pyloroplasty for treating peptic disease is considerable. The modification of the Sugiura-Futagawa procedure includes bilateral truncal vagotomy and pyloroplasty as part of the devascularization, with a low frequency of related complications.

AIM

To study the effects after VP in the outcome of both groups of patients.

RESULTS

The results of a retrospective, comparative, not randomized, controlled trial of 153 medical records of patients who underwent our modification of the Sugiura-Futagawa operation (SFO) due to Hemorrhagic Portal Hypertension (HPH), and 100 patients with bilateral truncal vagotomy and pyloroplasty (VP) due to Acid-Peptic Disease (APD) are presented. In both groups VP was done. The first group as part of SFO, and the second to treat their disease. We found 47 complications; 40 (40%) were observed in patients who underwent VP for APD and 7 (4%) in SFO: Post-vagotomy Diarrhea (PVD): 11% after APD and 2% after SFO. Dumping Syndrome (DS): 22% and 1%, and Alkaline Reflux Gastritis (ARG): 7% and 0.5% respectively. The calculated risk of developing complications related to vagotomy and pyloroplasty in peptic ulcer disease was 14 times higher.

CONCLUSIONS

The incidence of these post VP complications at the SFO group was low (4%), in relation to 40% for the APD; the outcomes were statistically significative (p < 0.05).

摘要

背景

迷走神经切断术和幽门成形术治疗消化性疾病的并发症发生率相当高。杉浦-二川手术的改良包括双侧迷走神经干切断术和幽门成形术作为去血管化的一部分,相关并发症发生率较低。

目的

研究迷走神经干切断术和幽门成形术(VP)对两组患者预后的影响。

结果

本文展示了一项回顾性、非随机、对照试验的结果,该试验涉及153例因出血性门静脉高压(HPH)接受我们改良的杉浦-二川手术(SFO)的患者以及100例因酸相关性疾病(APD)接受双侧迷走神经干切断术和幽门成形术(VP)的患者的病历。两组均进行了VP。第一组作为SFO的一部分,第二组用于治疗其疾病。我们发现了47例并发症;40例(40%)出现在因APD接受VP的患者中,7例(4%)出现在SFO组:迷走神经切断术后腹泻(PVD):APD后为11%,SFO后为2%。倾倒综合征(DS):分别为22%和1%,碱性反流性胃炎(ARG):分别为7%和0.5%。消化性溃疡疾病中与迷走神经切断术和幽门成形术相关的并发症发生风险经计算高出14倍。

结论

SFO组VP后这些并发症的发生率较低(4%),而APD组为40%;结果具有统计学意义(p < 0.05)。

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