[Comparative study of vascularization of the stomach after hyperselective vagotomy and anterior seromyotomy]

Based on a Micropaque arteriography study of 21 stomachs from non-embalmed adults, the authors compare the ischemic consequences of highly selective vagotomy (HSV) with those of anterior seromyotomy (ASM) combined with posterior trunk vagotomy. HSV inevitably produced an avascular band 2-4 cm wide in the lesser curve region. ASM, to be total and effective, needs to produce hemostasis of the submucosal plexus thereby also producing ischemia of the denuded mucososubmucosal band. It is however possible to avoid the submocosal plexus by remaining more superficial; however, it is then necessary to combine an additional neurotomy otherwise the procedure is likely to fail. In any event, the partial ischemia associated with ASM is much less serious than that noted after HSV.