Artículos de revistas
Late Follow-up Of Gastrectomized Patients For Peptic Ulcer: Clinical, Endoscopic And Histopathological Aspects [avaliação Tardia De Doentes Gastrectomizados Por úlcera Péptica: Aspectos Clínicos, Endoscópicos E Histopatológicos]
Registro en:
Arquivos De Gastroenterologia. , v. 42, n. 3, p. 146 - 152, 2005.
42803
2-s2.0-27344434668
Autor
Coelho-Neto J.D.S.
Andreollo N.A.
Lopes L.R.
Nishimura N.F.
Brandalise N.A.
Leonardi L.S.
Institución
Resumen
Background - The gastrectomy is an uncommon procedure because the proton bomb inhibitors associated to the antibiotic outlines used to eradicate the Helicobacter pylori changed the focus of the peptic ulcer treatment. Aims - Later evaluation on those patients who underwent partial gastrectomy as a treatment for peptic ulcer, at that time when any drug to eradicate the Helicobacter pylori was not used. The clinical evaluation included the late postoperative symptoms and postgastrectomy syndromes like dumping, diarrhea, alkaline gastritis and nutritional aspects. The upper digestive endoscopy analysed the surgery reconstruction and the gastric stump, the duodenum and the jejunum mucosa aspects. The histopathological evaluation included looking for Helicobacter pylori by using two different methods: histology and urease test. Casuistic and Methods - Fifty-nine patients, 44 (74.6%) male, median age 55.5 years old (range from 31 to 77 years old), who underwent a clinical interview and an upper digestive endoscopy. Paraffin blocks from the surgical specimen were reviewed in order to find out if the patients did have or did not have Helicobacter pylori before surgery. Results - The final results show that most of the patients had very good and good clinical evolution (Visick I e II) in 96%. The most common symptoms on late postoperative are mild dyspepsia with or without Helicobacter pylori, and diarrhea, anemia and dumping occurred in, respectively, 11 (18.6%), 2 (3.4%) and 2 (3.4%) cases. The Billroth I reconstruction had the best clinical results on statistical rate. The endoscopic finding showed normal results in the most number of cases, and reflux alkaline gastritis or erosive gastritis in a few cases. Ulcer recurrences were diagnosed in two patients (3.4%), and both had positive Helicobacter pylori. 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