Modified segmental gastrectomy combined with vagotomy for a gastric ulcer near the gastro-esophageal junction.
To avoid proximal gastrectomy which destroys the gastroesophageal closing mechanism, modified segmental gastrectomy with vagotomy was performed on 3 patients with gastric ulcers located in the stomach near the gastro-esophageal junction. These were all patients in whom a proximal gastrectomy would usually have been performed. The proximal line of resection did not encroach upon the mucosal rosette being within 1 cm of it following the margin of the ulcer. In each patient, the modified segmental resection of the upper stomach consisted of the surgical removal of a continuous strip of tissue including the ulcer and ulcer-bearing area along the wall followed by an end to end gastro-gastrostomy. In the 10 years following surgery, there have been no signs of reflux esophagitis, stricture, or recurrent ulcers in any of the 3 patients. This modified segmental gastrectomy with vagotomy is therefore recommended for gastric ulcers located near the gastro-esophageal junction.
Yoshiya
K
K
Second Department of Surgery, Hyogo College of Medicine, Japan.
Ishikawa
Y
Y
D004943:Esophagogastric Junction; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D013276:Stomach Ulcer / Q000601:surgery*; D014629:Vagotomy, Proximal Gastric