Evolution of gastric ulcer surgery

Evolución de la cirugía del Ulcus gástrico

Suiffet, Walter

Resumen:

The author analyzes the evolution of the gastric ulcer surgery along one century. Rydiguier performed the first gastrectomy because of gastric ulcer en 1881. He was successful and he went on performing it in spite of the difficulties of the time. The use of vagotomy has been greatly questioned and experience does not seem to be favorable, considering the unequal results. It is considered that the G U surgery requires, as a fundamental element, the exeresis of the lesion and a wide resection of the lesser curvature and a correct resection of the area where there are lesions of the gastric mucosa that tend to the appearance of the gastric ulcer. There is no reason for a resection of more than 40% of the stomach- except in the cases of acid hypersecretion. In case of risk of general arder, more conservative tactics may be used. Tactics must be adjusted to the topography of the lesion and the secretorial activity of each case. Tactics of high and juxtacardial GU are not analyzed. Mortality and relapse rates are analyzed.


Se analiza la evolución de la cirugía del Ulcus gástrico en el correr de un siglo. Rydygier realizó la primera gastrectomía por U.G. en 1881. Obtuvo éxito y la siguió practicando, a pesar de las dificultades de la época. La utilización de la vagotemia ha sido muy cuestionada y la experiencia parece no ser favorable, dado los resultados dispares. Se considera que la cirugía del U.G. exige como elemento fundamental, la excerésis de la lesión y una resección amplia de curva menor y correcta de la zona donde existen lesiones de la mucosa gástrica, que propenden a la aparición del U.G. No existe razón para una resección mayor que el 40% del estómago, salvo en los casos de hipersecreción ácida. Se pueden utilizar tácticas más conservadoras, en casos de riesgo de orden general. La táctica se debe ajustar a la topografía de la lesión y a la actividad secretoria de cada caso. No se analiza la táctica del U.G. alto y juxtacardial. Se analizan las cifras de mortalidad y de recidivas.


Detalles Bibliográficos
1982
gastrectomía
gastrectomy
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/3574
Acceso abierto
Resumen:
Sumario:The author analyzes the evolution of the gastric ulcer surgery along one century. Rydiguier performed the first gastrectomy because of gastric ulcer en 1881. He was successful and he went on performing it in spite of the difficulties of the time. The use of vagotomy has been greatly questioned and experience does not seem to be favorable, considering the unequal results. It is considered that the G U surgery requires, as a fundamental element, the exeresis of the lesion and a wide resection of the lesser curvature and a correct resection of the area where there are lesions of the gastric mucosa that tend to the appearance of the gastric ulcer. There is no reason for a resection of more than 40% of the stomach- except in the cases of acid hypersecretion. In case of risk of general arder, more conservative tactics may be used. Tactics must be adjusted to the topography of the lesion and the secretorial activity of each case. Tactics of high and juxtacardial GU are not analyzed. Mortality and relapse rates are analyzed.