[Diseases caused by sutures following stomach operations--yes or no?]

The importance of remaining suture material in the operated stomach was studied on two groups of patients. Group I consisted of 560 patients who were found among about 6,000 gastroscopically examined patients. Group II consisted of 102 non-selected patients who underwent a gastric operation and in certain intervals were repeatedly examined gastroscopically and clinically after operation. The most frequent gastric operation was Billroth II, followed by Billroth I and the selective proximal vagotomy with pyloroplasty. Group I shows that the proof of suture material in the operated stomach depends on the postoperative time interval. During the first postoperative year the proof is most frequent with 48.5% and permanently decreases in the following years. After the 15th postoperative year no threads were found. Suture material could be more frequently proved in the Billroth I stomach (52.5%) than in the Billroth II stomach (21.7%). In group II in 56% of the patients suture material was found in the stomach. Also here the Billroth I stomach was at the top. The analysis of the complaints in patients with and without suture material resulted in the fact that remaining suture material is responsible for epigastric complaints and complications such as ulcer and haemorrhage. The notion of "thread disease" is justified. The frequency of the symptomatic thread disease during the first two years after operation is 30%. A plan of measures for the decrease of this complication is proposed which among others provides the use of absorbable suture material for all sutures at the stomach and demands the endoscopic removal of all rests of sutures.