Recurrence rate after highly selective vagotomy

Busman, D.C.; Volovics, A.; Munting, J. D. K.

doi:10.1007/bf01658058

Cited by 7 publications

(2 citation statements)

References 37 publications

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“…Bei Studien mit einem langen Beobachtungszeitraum wurden vereinzelt noch nach 10 bzw. [2] schlugen aus diesem Grund ein anderes Beurteilungskriterium vor. Busman etal.…”

Section: Patientengutunclassified

Billroth-I-Hemigastrektomie beim komplizierten Ulkusrezidiv nach selektiv proximaler Vagotomie

Arlt

Peiper

Winkeltau

et al. 1993

Langenbecks Arch Chiv

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The outcome of Billroth I hemigastrectomy for complicated recurrent ulcers after proximal selective vagotomy (PSV) for duodenal ulcer was analyzed in a retrospective study of 15 patients followed up for 15-81 months (mean 3.8 years) postoperatively. Bleeding was reported in 4, stenosis in 5, penetration in 3, perforation in 1 and refractory ulcer in 2 cases. None of the patients died during revision surgery, and none developed ulcer recurrence. In 4 patients complications were seen, including bleeding requiring relaparotomy (1) and subhepatic hematoma (3). In 12 patients (80%) a good or excellent result (Visick I/II) was seen at follow-up. Reasons for Visick III or Visick IV classification were reflux esophagitis grades I and II in 2 cases and refractory dyspeptic symptoms in 1 case. Distal gastric resection with a Billroth I anastomosis for complicated recurrent ulcer after PSV proved to involve only low morbidity and to effect reliable prophylaxis of ulcer recurrence in the long term.

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“…Bei Studien mit einem langen Beobachtungszeitraum wurden vereinzelt noch nach 10 bzw. [2] schlugen aus diesem Grund ein anderes Beurteilungskriterium vor. Busman etal.…”

Section: Patientengutunclassified

Billroth-I-Hemigastrektomie beim komplizierten Ulkusrezidiv nach selektiv proximaler Vagotomie

Arlt

Peiper

Winkeltau

et al. 1993

Langenbecks Arch Chiv

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“…The lay logic of the patient may be, in other words, a more significant determinant of outcome, broadly defined, than medically, surgically or economically specified criteria. Add to that the fact that the self‐assessments patients may make of their own health may be extremely variable, any attempt to impose external measures may have only a tangential bearing on outcome, however it is defined (Busman et al 1988). What does that matter if the task of audit is to measure efficiency and effectiveness?…”

Section: Some Examples Of the Technik Approachmentioning

confidence: 99%

A suitable case forTechnik:behavioural science in the postgraduate medical curriculum

Kelly

1990

Medical Education

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The role of the behavioural and social sciences in the postgraduate medical curriculum is considered. It is argued that the behavioural and social sciences can play a vigorous and dynamic part both in medical education and in medical practice. However, in order for that role to be achieved a Technik approach must be adopted. Technik means an emphasis on know-how, capability and on unifying theory and practice. It is suggested that the behavioural sciences frequently fail to excite interest because they adopt only a humanistic and/or critical approach at the expense of the needs of medical training. Some examples of a Technik approach drawn from health education, the management of chronic disease and surgical audit are briefly examined.

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Complications associated with ulcer recurrence following gastric surgery for ulcer disease

1992

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The present study is an attempt to assess the risks of the complications associated with recurrent ulcers in patients who have undergone gastric surgery and to determine whether these risks differ from those observed in patients receiving long term maintenance treatment with H2-receptor antagonists for ulcer disease. One hundred and thirty studies reported in the literature during the past three decades have been analysed to determine both the approximate rate of ulcer recurrence and the proportion of patients with recurrent ulcers who have presented with either haemorrhage or perforation following the various types of gastric surgery for ulcer disease. From these data, estimates of the risks of haemorrhage and of perforation during the years following gastric surgery have been calculated. Vagotomy and antrectomy is associated with a low risk of ulcer recurrence (less than 1%) and the risk of complications in later years is accordingly very small (less than 0.5%). Partial gastrectomy, although associated with low recurrence rates, has a higher risk of complications (1.3% for haemorrhage, 0.3% for perforation) because the proportion of recurrent ulcers that present with haemorrhage or perforation is high (33% and 8%, respectively). Truncal vagotomy plus drainage (TV + D) and highly selective vagotomy (HSV) are associated with recurrence rates of 9% and 12%, respectively, but ulcer recurrences following these operations are less frequently accompanied by complications then recurrences after gastric resection and, as a result, the risks of haemorrhage (1.7% for TV + D; 1.3% for HSV) are similar to the risks after gastric resection. During long term (five years or more) maintenance treatment with H2-receptor antagonists, the risks of haemorrhage and perforation are less than 2% and less than 0.5%, respectively. It appears, therefore, that the likelihood of developing haemorrhage or perforation following gastric surgery is of the same order as that during maintenance treatment with H2-receptor antagonists, at least during the first decade of follow-up.

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Recurrence rate after highly selective vagotomy

Cited by 7 publications

References 37 publications

Billroth-I-Hemigastrektomie beim komplizierten Ulkusrezidiv nach selektiv proximaler Vagotomie

Billroth-I-Hemigastrektomie beim komplizierten Ulkusrezidiv nach selektiv proximaler Vagotomie

A suitable case forTechnik:behavioural science in the postgraduate medical curriculum

Complications associated with ulcer recurrence following gastric surgery for ulcer disease

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