Reck T, Köckerling F, Schneider C, Hohenberger W
Chirurgische Klinik mit Poliklinik, Friedrich-Alexander Universität Erlangen-Nürnberg.
Zentralbl Chir. 1997;122(7):586-90.
Abdominal re-operation in patients with recurrent peptic ulcer disease is associated with a high morbidity rate and a mortality rate of 5%. As an alternative procedure, therefore, transthoracic truncal vagotomy was early recommended as a less invasive intervention, and good results can be achieved with it. With the development of minimal invasive surgery, this procedure can now be performed via thoracoscopy and patient stress thus reduced even further. Via a left-sided thoracoscopy, the parietal pleura is incised and a 3-5 cm long segment of the distal oesophagus mobilised and dissected free. Both the posterior and anterior trunks of the vagus nerves are identified and, after applying clips, transected. In order to achieve complete vagotomy, further fine branches have to be searched out and, if found, also divided.
复发性消化性溃疡疾病患者的腹部再次手术与高发病率和5%的死亡率相关。因此，作为一种替代手术，早期推荐经胸迷走神经干切断术作为一种侵入性较小的干预措施，并且可以取得良好效果。随着微创手术的发展，现在可以通过胸腔镜进行该手术，从而进一步减轻患者的应激反应。通过左侧胸腔镜，切开壁层胸膜，游离并解剖出一段3 - 5厘米长的远端食管。识别迷走神经的前后干，夹闭后切断。为了实现完全迷走神经切断，必须找出并切断更多细小分支。
