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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2000 December;41(6):941-3

THORACIC PAPERS 

    ORIGINAL ARTICLES

Thoracoscopic truncal vagotomy

Gullà P., Tassi A., Cirocchi R., Longaroni M.

From the Gen­eral Sur­gery ­Unit Hos­pital of ­Foligno, ­Perugia, Italy

Back­ground. Now­a­days the ­only indi­ca­tions to ­truncal ­vagotomy is recur­rent ulcer­a­tion ­after pre­vious gas­tric sur­gery. ­Truncal ­vagotomy ­allows us to ­obtain a reduc­tion in ­acid pro­duc­tion and to pro­mote ­ulcer ­healing, but ­this tech­nique ­causes pylo­ros­pasm in ­about 20% of ­cases and ­this ­requires fur­ther syn­chro­nous or met­a­chro­nous ­pyloric ­drainage pro­ce­dure. For ­this ­reason, vid­eo­tho­rac­os­copic ­truncal ­vagotomy is ­reserved to ­patients ­with gas­tror­e­sec­tion.
­Methods. The ­authors ­describe 15 ­patients ­treated ­with vid­eo­tho­rac­os­copic ­truncal ­vagotomy. In 12 ­patients, a gas­tro­jej­u­nos­tomy was ­done ­according to ­Roux tech­nique in 2 ­patients, a recon­struc­tion ­according Bill­roth II tech­nique and in 1 ­patient, a gas­trod­u­od­e­nos­tomy ­according to Bill­roth I tech­nique.
­Results. Vid­eo­tho­rac­os­copic bilat­eral ­truncal ­vagotomy was ­done in all ­patients; oper­a­tion ­time was 45 min­utes. ­During the ­postoper­a­tive ­period ­there ­were no com­pli­ca­tions. No ­patients under­went med­ical ­therapy for ­peptic ­ulcer. ­Only in 12 ­patients was it pos­sible to exe­cute an endo­scopic ­follow-up in a ­period of 3 to 4 ­years. In all ­patients the ­ulcer was com­pletely ­healed.
Con­clu­sions. Com­plete ­vagotomy in ­patients who ­present ­with recur­rent gas­troin­tes­tinal ­bleeding ­after pre­vious gas­tror­e­sec­tion, is asso­ciated ­with sig­nif­i­cant ­risks. Vid­eo­tho­rac­os­copic bilat­eral ­truncal ­vagotomy as a ­simple and effi­cient pro­ce­dure ­seems to be an alter­na­tive treat­ment for the man­age­ment of recur­rent ulcer­a­tion ­after pre­vious gas­tric sur­gery for ­peptic dis­ease.

language: English


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