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Titolo:
Operations for peptic ulcer disease: Paradigm lost
Autore:
Schwesinger, WH; Page, CP; Sirinek, KR; Gaskill, HV; Melnick, G; Strodel, WE;
Indirizzi:
Univ Texas, Hlth Sci Ctr, Dept Surg, Sect Gen Surg, San Antonio, TX 78229 USA Univ Texas San Antonio TX USA 78229 t Gen Surg, San Antonio, TX 78229 USA Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA Univ Texas San Antonio TX USA 78229 Pharmacol, San Antonio, TX 78229 USA S Texas Vet Hlth ctr, San Antonio, TX USA S Texas Vet Hlth ctr San Antonio TX USA et Hlth ctr, San Antonio, TX USA
Titolo Testata:
JOURNAL OF GASTROINTESTINAL SURGERY
fascicolo: 4, volume: 5, anno: 2001,
pagine: 438 - 443
SICI:
1091-255X(200107/08)5:4<438:OFPUDP>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
HELICOBACTER-PYLORI ERADICATION; GASTRIC OUTLET OBSTRUCTION; PROTON-PUMP INHIBITORS; DUODENAL-ULCER; UNITED-STATES; ENDOSCOPIC HEMOSTASIS; PREVENTS RECURRENCE; BALLOON DILATION; TIME TRENDS; SURGERY;
Keywords:
peptic ulcer disease; gastroduodenal ulcers; Helicobacter pylori; endoscopic hemostasis; ulcer operations;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
52
Recensione:
Indirizzi per estratti:
Indirizzo: Schwesinger, WH Univ Texas, Hlth Sci Ctr, Dept Surg, Sect Gen Surg, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA Univ Texas 7703 Floyd Curl Dr San Antonio TX USA 78229 USA
Citazione:
W.H. Schwesinger et al., "Operations for peptic ulcer disease: Paradigm lost", J GASTRO S, 5(4), 2001, pp. 438-443

Abstract

Over the past several decades, the pharmacologic and endoscopic treatment of peptic ulcer disease (PUD) has dramatically improved. To determine the effects of these and other changes on the operative management of PUD, we reviewed our surgical experience with gastroduodenal ulcers over the past 20 years. A computerized surgical database was used to analyze the frequenciesof all operations for PUD performed in two training hospitals during four consecutive 5-year intervals be inning in 1980. Operative rates for both intractable and complicated PUD were compared with those for other general surgical procedures and operations for gastric malignancy. In the first 5-year period (1980 to 1984), a yearly average of 70 upper gastrointestinal operations were performed. This experience included 36 operations for intractability, 15 for hemorrhage, 12 for perforation, and seven for obstruction. During die same time span, 13 resections were performed annually for gastric malignancy. By the most recent 5-year interval (1994 to 1999), the total number of upper gastrointestinal operations had declined by 80% (14 cases), although the number of operations for gastric cancer had changed only slightly. Operations decreased most markedly for patients with intractability, but the prevalence of operations for bleeding, obstruction, and perforation was also decreased. We conclude that improved pharmacologic and endoscopic approaches have progressively curtailed the use of operative therapy for PUD. Elective surgery is now rarely indicated, and emergency operations are much less common. This changed paradigm poses new challenges for training andsuggests different approaches for practice.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 08:30:01