The aarhus county vagotomy trial

Amdrup, E; Andersen, Ditte K.; Høstrup, H

doi:10.1007/bf01574469

Cited by 73 publications

(12 citation statements)

References 12 publications

(12 reference statements)

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“…Only continued follow-up until a sizable number of patients have been observed for at least l0 years will be able to show whether the delayed peak of recurrences will be shortlasting. Although the recurrence rate for PCV so far observed in this study is high, we do not find it unacceptable in view of the freedom from other sequelae [1,2]. Other findings concerning recurrence rate 5 years or more after PCV are not very different from ours.…”

Section: Discussioncontrasting

confidence: 89%

The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage

et al. 1982

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In a prospective, randomized study, 691 patients with duodenal (DU), pyioric (PU), or prepyloric (PPU) ulcers have been followed for 2-5 years after operation with parietal cell vagotomy (PCV) or selective gastric vagotomy with drainage (SGV + D). About half the patients have been followed for 5 years. Cumulative 5-year recurrence rates, calculated by a life table method, suggest a higher recurrence rate for patients with DU when operated with PCV (15%) than when operated with SGV + D (9%), but the difference was not statistically significant (p > 0.05). Patients with PU/PPU had higher recurrence rates following either procedure than patients with DU (PCV: 33%; SGV + D: 14%).A study of the change in recurrence risk as a function of time after operation suggests that the recurrence rate following SGV + D when used for DU will continue to rise after 5 years, but probably very slowly. The recurrence rate after 5 years is unpredictable, however, for PCV when used for DU, and unpredictable for both methods when used for PU/PPU.The recurrence rate was found to be independent of the level of preoperative gastric acid secretion, and this was true for both PCV and SGV + D. An increased recurrence rate was, on the other hand, found to be associated with < 50% postoperative reduction in pentagastrin-stimulated acid secretion.

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Section: Discussioncontrasting

confidence: 89%

The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage

et al. 1982

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“…Four types of operations were performed: selective gastric vagotomy with drainage (SGV + D), selective vagotomy with antrectomy (SGV + A), parietal cell vagotomy with drainage (PCV + D), and parietal cell vagotomy without drainage (PCV). The principles for randomization have been described previously [10,11].…”

Section: Methodsmentioning

confidence: 99%

Survival after vagotomy: Results of the Aarhus county vagotomy trial

Ditlevsen

1989

World j. surg.

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In order to investigate whether the previously found excess mortality in surgically-treated patients with peptic ulcer might be due partly to the resections employed, a survival analysis was undertaken in 824 patients 8-13 years after different types of vagotomy. These patients had been submitted to selective gastric vagotomy with drainage, selective gastric vagotomy with antrectomy or parietal cell vagotomy with or without drainage for duodenal ulcer, pyloric ulcer, prepyloric ulcer, or combined ulceration during the period from 1972 to 1977. A statistically significant excessive mortality was found for both sexes in the total material compared to the background population. Analysis of the material, subdivided according to the operative methods employed, revealed a significant excess mortality in men treated with selective gastric vagotomy and antrectomy, whereas the mortality rates were slightly and insignificantly raised in the nonantrectomy groups. No significant difference in the mortality could be demonstrated in relation to the site of the ulcers. Analysis of the cause-specific mortality revealed a significantly raised mortality from gastrointestinal diseases, including a significant excessive mortality in the subgroups of benign peptic ulcer and cirrhosis of the liver. Likewise, the death rate from accidents including the subgroup of suicide was significantly increased. The overall mortality from malignancies was insignificantly raised among patients, whereas cancer in the stomach was significantly increased. An increased mortality from cancer in the lungs and pancreas did not reach statistical significance. These findings are in reasonable accordance with other studies. A significantly increased mortality from gastric cancer has been usual, although not a constant finding after gastric resection.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Eligible for the study were patients with endoscopically proven ulcers in the duodenal bulb (DU), in the pyloric ring (PU), and in the prepyloric zone (PPU) including Ulcers with their anal margin 2 cm or less from the pylorus. Furthermore, the severity of disease had to indicate surgical treatment after pre-cimetidine criteria [2], and the patients all accepted operation in case of failure of conservative treatment. Patients who had received cimetidine before the trial were excluded.…”

Section: Methodsmentioning

confidence: 99%

Surgery or cimetidine? II. Comparison of two plans of treatment: Operation or cimetidine given as a low maintenance dose

Andersen

Amdrup

et al. 1983

World j. surg.

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The aim of this study was to compare the effect of 2 therapeutic schemes on the final treatment of patients with duodenal ulcer disease severe enough to indicate surgery. One group was randomized to cimetidine 1 g/day for 8 weeks and operation was suggested in case of symptomatic recurrence. The other group was given a prophylactic dose of cimetidine 400 mg at night after the full‐dose course and operation was suggested in case of symptomatic recurrence during the maintenance treatment. The study showed that cimetidine on a long‐term basis substantially reduced the tendency to symptomatic recurrence of duodenal ulcer. The effect on the operation rate, however, was rather modest and was in essence a postponement rather than a prevention. In regard to ability to reduce the number of patients operated on, the result of maintenance therapy was very similar to the result seen in a previous study on intermittent courses of cimetidine. This and our earlier study suggest that operative treatment will still be the choice of the majority of patients with severe duodenal ulcer disease, and that neither intermittent nor continuous cimetidine treatment will radically change this. An important effect of cimetidine is that some patients can be treated without operation because of very long remissions, and that other patients in a high‐risk group can be kept on cimetidine. The value judgment of patients may, however, change with time, because medical treatment will decrease the symptomatic strain on the future ulcer patients as compared to patients remaining from the precimetidine era.

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The aarhus county vagotomy trial

Cited by 73 publications

References 12 publications

The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage

The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage

Survival after vagotomy: Results of the Aarhus county vagotomy trial

Surgery or cimetidine? II. Comparison of two plans of treatment: Operation or cimetidine given as a low maintenance dose

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