https://scholars.lib.ntu.edu.tw/handle/123456789/477679
標題: | Surgical treatment of peptic ulcer disease: Changing patterns in the past 40 years | 作者: | CHIUNG-NIEN CHEN Lee W.-J. PO-HUANG LEE KING-JEN CHANG Wang S.-M. Wei T.-C. Chen K.-M. |
公開日期: | 1996 | 卷: | 95 | 期: | 9 | 起(迄)頁: | 675-679 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | During the past 40 years (1951-1990), 7,663 patients with peptic ulcer disease underwent surgical treatment at the National Taiwan University Hospital. A great change in patient characteristics and operative procedures was noted between the last 10 years and the previous three decades. There were 7,105 patients (92.7%) between 1951 and 1980, an average of 237 patients per year. However, only 558 patients received surgery in the last 10 years, an average of 56 patients per year. The proportion of female patients increased from 9.5% in the earlier period to 20.4% in the last 10 years; the average age of patients also increased. In the earlier period, the indications for surgery were hemorrhage (38.4%), perforation (36.1%), intractable pain (16.4%) and stenosis (9.1%). Perforation (89.2%) was the most common indication for surgical treatment in the last 10 years. Hemorrhage (4.9%), pain (4.1%) and stenosis (1.8%) were less common. There was no significant difference in surgical morbidity between the two periods. Primary subtotal gastrectomy (SG) accounted for 75.4% of operations in the earlier period, but vagotomy became the main treatment in the last 10 years, including highly selective vagotomy (HSV) (31.9%), and truncal vagotomy with drainage procedure (TV + D) (31.0%). The surgical mortality in the earlier period was 1.3% for SG, 1.8% for TV + D and 16.1% for simple closure. There was no significant change in ulcer location between the two periods. The overall mortality rate was higher in the last 10 years (5.2%) than in the earlier 30 years (2.7%) (p<0.001). In follow-up studies, the satisfactory rate after operation was similar among patients receiving SG (89.8%), HSV (90.3%) and TV + D (91.1%) between 1977 and 1990. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0030469804&partnerID=40&md5=a2dc58c6a3d69b1e17675f6849e71e6c https://scholars.lib.ntu.edu.tw/handle/123456789/477679 |
ISSN: | 0929-6646 | SDG/關鍵字: | adolescent; adult; aged; article; child; female; gastrectomy; human; major clinical study; male; peptic ulcer; surgical technique; treatment indication; treatment outcome; vagotomy; Adolescent; Adult; Aged; Aged, 80 and over; Child; Duodenal Ulcer; Female; Gastrectomy; Humans; Male; Middle Aged; Pyloric Antrum; Retrospective Studies; Sex Characteristics; Stomach Ulcer; Vagotomy, Proximal Gastric |
顯示於: | 醫學系 |
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