Summary
The technique of preserving the antral vagal nerve supply of the stomach and division of the gastric branches of the nerves of Latarjet is common to both operations, but by replacing the transection of the hiatal cardioesophageal vagus nerve branches (including the nerve branches accompanying the arteries entering the fundus of the stomach) with a transgastric intramural transection and excision of all nerve fibers entering the fundus, a highly selective vagotomy is achieved. Completeness of HSTRV is controlled intraoperatively by a gastric pH meter and by measuring the oxygen tension of the gastric mucosa. One year to 18 months after application of HSTRV in 74 patients with uncomplicated duodenal ulcers, mortality was nil, morbidity insignificant, the previous ulcer symptoms no longer present, and dumping syndrome, recurrence and other significant complications were not observed.
Zusammenfassung
Die Technik der Schonung der Vagus-Innervation des Magen-Antrums, und die Durchtrennung der transversalen Äste der Nn. Latarjet ist dieselbe bei beiden Operationen, aber die Durchtrennung der cardioesophagealen Äste des Vagus und der Nerven, welche die in den Magenfundus eintretenden Magenarterien begleiten, ist ersetzt worden durch die transgastrische intramurale Durchtrennung und Excision aller sichtbaren Nervenäste, welche am Magenfundus eintreten. Vollständigkeit dieser Vagotomie wird intraoperativ kontrolliert mittels gastrischer pH-Messung und Messung des Sauerstoffgewebdruckes an der Magenschleimhaut. Ein Jahr bis 18 Monate nach der proximalen transgastrischen Vagotomie bei 74 Patienten mit unkompliziertem Duodenalgeschwür war die Mortalität nihil, die Morbidität unbedeutend, die Symptome der vorhergehenden Ulcera waren verschwunden und Dumping Syndrom, Ulcusrezidiv oder andere bedeutende Komplikationen wurden nicht beobachtet.
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Petropoulos, P.C. Transgastric highly selective vagotomy (HSTRV) without drainage. Langenbecks Arch Chiv 350, 95–101 (1979). https://doi.org/10.1007/BF01234291
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DOI: https://doi.org/10.1007/BF01234291