SURGICAL TREATMENT OF MEDIAGASTRIC ULCERS

Abstract

In the authors' article, in the surgical treatment of mediagastric ulcers, in recent years surgical methods have been actively developed to preserve the pyloric sphincter of the stomach and the innervated antrum [7,11,12]. At the same time, the motor-evacuation activity of the gastroduodenal complex is preserved and ensures the natural passage of chyme. This helps to improve long-term functional results of surgical treatment. The conditions for achieving adequate functioning of the remaining parts of the stomach are: their innervation, blood supply and restoration of the anatomical shape corresponding to the functions they perform.

It is known that mediogastric ulcers are located on the lesser curvature of the stomach, and due to the topography of the innervation of the stomach, vessels and vagus nerves, the pathological process in the stomach at any level (bodily or cardiac) the ulcer or ulcerative infiltrate spreads to the lesser carva, which is the left gastric artery and ensures the achievement of the pathological process of the main body of the vagus nerve. In such cases, removal of the wound will certainly lead to damage to blood vessels and nerves, disruption of the blood supply and innervation of the gastroduodenal complex, and if the trunk of the vagus nerve is damaged, this will lead to disruption of the functioning of the pancreaticoduodenal complex. system, liver and extrahepatic bile ducts [7].

Based on the results of the experiment and clinical observations, a surgical method for the treatment of mediogastric gastric ulcers has been proposed - an economical gastrectomy, performed in conjunction with an incision of the lesser curvature and selective vagotomy. The clinic operated on 20 patients using this method. Good results were observed in 95% of them.