Læknablaðið - 15.04.1985, Page 13

LÆKNABLAÐIÐ
85
blönduðum hópi sjúklinga eru 6.8% í Visick-
flokki III og IV. í kanadísku uppgjöri (13) á
sári í skeifugörn, er tíðni endurmyndunar sára
6,5%. Ef við miðum útreikninga okkar við þá
sem hafa sár í skeifugörn eingöngu, falla
6.7% sjúklinga undir Visick-flokk III, þ.e.
ófullnægjandi árangur aðgerðar.
Af þessum 35 sjúklingum hafði enginn
fengið einkenni um hraða tæmingu maga
(dumping) eftir aðgerð. Saga um niðurgang
kom fram hjá sjö, en hjá fimm þeirra var hann
sjaldgæft fyrirbæri og þarfnaðist ekki
meðferðar. Þessi lága tíðni fylgikvilla er einn
helsti kostur þessarar aðgerðar (2, 4, 10, 13).
Hnitrof á skreyjutaug hefur í för með sér
hærri tíðni endurmyndaðra sára en aðrar
aðgerðir við ætisári í maga og skeifugörn.
Hinsvegar eru flestir sammála um, að þessi
endurmynduðu sár séu yfirleitt léttbærari, en
þau sár er voru fyrir og svari betur lyfja-
meðferð.
Fyrst flutl sem erindi á aðalfundi Skurðlæknafélags íslands í
Borgarnesi 27. apríl 1984, af öðrum höfundi (MO) þessarar
greinar.
SUMMARY
Highly Selective Vagotomy in 35 patients at St. Joseph’s
Hospital, Reykjavík 1977-1983.
A review of thirty five cases of highly selective
vagotomy is presented. During the years 1977-1983,
fifteen females and twenty males were treated for peptic
ulcer with highly selective vagotomy. Twenty-five of the
patients had duodenal and/or pyloric ulcer, five patients
had gastric ulcer, one had both duodenal and gastric
ulcer. Four of the patients had chronic gastro-duodenitis.
Prior efforts of medical treatment had been made for all
patients, without satisfactory results.
Early in 1984 all thirty-five patients were contacted.
They had all been under observation after surgery for a
period of five months to six years, the mean observation
time being 2,8 years. All patients were in good health.
None had been admitted to hospital due to peptic ulcer.
Two patients had symptoms of peptic ulcer, but milder
than before operation and were easily controlled by
medication. Nine patients had symptoms of the previous
disease, but not influencing their life-style. No case of
dumping was found. By the modified Visick grading
system, 33 are in group I and II, but two in group III. A
recurrence rate of 5.7 percent compares favourably with
current literature.
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