122. Oesophagitis und OesophaguBtriktur nach Gastrektomie

1435-2451

Gastrectomy ; Carcinoma, gastric ; Esophagitis ; Magenresektion ; Magen-Carcinom ; Oesophagitis

Springer Online Journal Archives 1860-2000

Medicine

ZusammenfaBung Oesophagitis und OesophaguBtriktur nach totaler Gastrektomie sind recht allgemeine Komplikationen, die den Hauptanteil der postoperativen Beschwerden dieser Patienten verursachen. Da diese Patienten oft in schlechtem Zustand sind, ist das Risiko operativer Eingriffe groB und wir sind deshalb mit recht guten Resultaten zur Anwendung von Eder-Puestow-Dilatatoren übergegangen. Das Perforationsrisiko ist gering und ebenso anschlieBend die Möglichkeit einer Ruptur, falls genügende Vorsicht gewahrt wird.

Summary Of 189 patients operated on for gastric cancer from 1970 to 1975, total gastrectomy was performed in 22% (41) with a mortality of 12%. At follow-up of 2.5 years 56% of patients did not have esophageal symptoms, 25% had chronic, severe esophagitis, 36% developed stenosis. Malignant recidivations caused half of them and in the others the benign scar strictures were often combined with esophagitis. To decrease these late complications, emphasis was placed on preventing alkaline reflux by operative methods. The patients were examined endoscopically and when neceBary, Eder-Puestow dilators were used without complications. Strictures at anastomoses yielded best results. When stenosis and esophagitis were compined, it was in some cases neceBary to repeat dilatations, and in malignant strictures the complaints were relieved transiently.

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