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; RESULTS OF RESECTION METHODS OF TREATMENT IN PATIENTS WITH GIANT PYLORODUODENAL ULCERS COMPLICATED BY PERFORATION
A Kosenkov1, E Stoliarchuk1, E Belykh1
11Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Georgian Medical News
|September 23, 2020
Summary
This study on gastric resection for ulcers found that while early complications like stomach stump dysfunction and cardiovascular issues occurred in over half of patients, long-term results showed improved quality of life and no ulcer recurrence.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Medicine
Background:
- Peptic ulcer disease remains a significant cause of morbidity and mortality.
- Surgical intervention, including gastric resection, is a critical treatment option for complicated peptic ulcers.
- Evaluating the outcomes of different gastric resection techniques is essential for optimizing patient care.
Purpose of the Study:
- To analyze the immediate and long-term outcomes of various gastric resection methods for peptic ulcer disease.
- To compare the complication rates and functional results of standard gastric resection versus pylorobulbar resection with vagotomy.
- To assess the impact of surgical interventions on patient quality of life.
Main Methods:
- Retrospective analysis of 35 patients undergoing gastric resection between 2000 and 2019.
- Categorization of surgeries into standard gastric resection (Billroth-II) and pylorobulbar resection (Billroth-I) with vagotomy.
- Evaluation of early postoperative complications, including cardiovascular, respiratory, and gastrointestinal issues.
- Assessment of long-term results, focusing on functional disorders, ulcer recurrence, and quality of life.
Main Results:
- Early postoperative complications occurred in 51.4% of patients, with significant rates of stomach stump evacuation dysfunction (22.8%).
- Cardiovascular and respiratory complications were noted, alongside a 5.7% rate of suture failure.
- Mortality was 22.7%, primarily in patients undergoing urgent surgery for perforation or bleeding.
- Long-term follow-up revealed a decrease in post-gastric resection and post-vagotomy disorders, with no ulcer recurrence and satisfactory quality of life.
Conclusions:
- Gastric resection for peptic ulcer disease is associated with considerable early complications but offers favorable long-term outcomes.
- Standard gastric resection and pylorobulbar resection with vagotomy can lead to good functional results and improved quality of life in the long term.
- Careful patient selection and surgical technique are crucial for minimizing complications and ensuring positive long-term results.
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