Meta-analysis of highly selective vagotomy versus truncal vagotomy and pyloroplasty in the surgical treatment of uncomplicated duodenal ulcer.
OBJECTIVE
To compare critically by meta-analysis the postoperative outcomes after truncal vagotomy and pyloroplasty (TVP) and after highly selective vagotomy (HSV).


METHODS
A search was conducted on MEDLINE with the keywords "peptic ulcer" and "vagotomy". Bibliographics of the articles retrieved and review articles pertaining to the subject were scanned further.


METHODS
Included were only published prospective, randomized controlled trials comparing TVP and HSV in the English-language literature up to April 1991. Twelve studies were found.


METHODS
Two authors, working independently, abstracted raw data on mortality, recurrence, dumping, diarrhea and postoperative Visick grading.


RESULTS
A ratio greater than 1.0 indicates a higher proportion occurring with TVP and less than 1.0 a higher proportion with HSV. [Table: See Text]


CONCLUSIONS
The results suggest that the likelihood of adverse long-term sequelae is higher with TVP whereas the likelihood of recurrence is higher with HSV.
Chan
V M
VM
Department of Surgery, University of Toronto, Ont.
Reznick
R K
RK
O'Rourke
K
K
Kitchens
J M
JM
Lossing
A G
AG
Detsky
A S
AS
D016001:Confidence Intervals; D004381:Duodenal Ulcer / Q000601:surgery*; D006801:Humans; D016239:MEDLINE; D016017:Odds Ratio; D011706:Pyloric Antrum / Q000601:surgery; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D014629:Vagotomy, Proximal Gastric / Q000706:statistics & numerical data*; D015167:Vagotomy, Truncal / Q000706:statistics & numerical data*