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EARLY AND DELAYED CLINICAL EFFECTS OF VAGOTOMY FOR PEPTIC ULCER

EARLY AND DELAYED CLINICAL EFFECTS OF VAGOTOMY FOR PEPTIC ULCER Abstract BETWEEN Nov. 1, 1946 and Nov. 1, 1947, vagus resection for treatment of peptic ulcer, as recently advocated by Dragstedt,1 was performed in 42 cases at the Veterans Administration General Hospital at Los Angeles (Sawtelle), Calif. All patients were operated on by surgeons of the joint graduate teaching service of the University of Southern California, College of Medical Evangelists, and the University of California at Los Angeles medical schools. The patients, all men, varied in age from 20 to 68 years, the average age being 47½ years. One or more of the classic indications for surgical intervention in treatment of peptic ulcer were present in all cases, namely, (1) chronicity with poor response to, or inability to carry out, an adequate medical regimen, (2) hemorrhage and (3) obstruction. The duration of symptoms varied from four months to twenty years, the average being 11.2 years. Recurrent or intractable pain was References 1. (a) Dragstedt, L. R., and Owens, F. M.: Supradiaphragmatic Section of Vagus Nerves in Treatment of Duodenal Ulcer , Proc. Soc. Exper. Biol. & Med. 53:152-154, 1943. 2. (b) Dragstedt, L. R., and Schafer, P. W.: Removal of the Vagus Innervation of the Stomach in Gastroduodenal Ulcer , Surgery 17:742-749, 1945. 3. (c) Dragstedt, L. R.: Vagotomy for Gastroduodenal Ulcer , Ann. Surg. 122:973-989, 1945. 4. Moore, F. D.: Resection of the Vagus Nerves for Ulcer: An Interim Evaluation , Arch. Surg. 55:164-174 ( (Aug.) ) 1947. 5. Moore, F. D.; Chapman, W. P.; Schulz, M. D., and Jones, C. M.: Transdiaphragmatic Resection of the Vagus Nerves for Peptic Ulcer , New England J. Med. 234:241-251, 1946 6. Vagus Resection in Peptic Ulcer: Physiologic Effects and Clinical Results , J. A. M. A. 133:741-759 ( (March 15) ) 1947. 7. Grimson, K. S.; Baylin, G. J.; Taylor, H. M.; Hesser, F. H., and Rundles, R. W.: Transthoracic Vagotomy: The Effects in Fifty-Seven Patients with Peptic Ulcer and the Clinical Limitations , J. A. M. A. 134:925-932 ( (July 12) ) 1947. 8. Crandell, W. B.; Boehm, W. E., and Mulholland, J. H.: Effects of Supradiaphragmatic Section of the Vagus Nerves in Man , Arch. Surg. 55:343-348 ( (Sept.) ) 1947. 9. Thornton, T. F., Jr.; Storer, E. H., and Dragstedt, L. R.: Supradiaphragmatic Section of the Vagus Nerves: Effect on Gastric Secretion and Motility in Patients with Peptic Ulcer , J. A. M. A. 130:764-771 ( (March 23) ) 1946. 10. Walters, W.; Neibling, H. A.; Bradley, W. F.; Small, J. T., and Wilson, J. W.: Gastric Neurectomy: Anatomic and Physiologic Studies with Favorable and Unfavorable Results in the Treatment of Peptic Ulcer , Arch. Surg. 55:151-163 ( (Aug.) ) 1947. 11. Walters, W.; Neibling, H. A.; Bradley, W. F.; Small, J. T., and Wilson, J. W.: Gastric Neurectomy for Gastric and Duodenal Ulceration: An Anatomic and Clinical Study , Ann. Surg. 126:1-18, 1947. 12. Grimson, K. S.; Baylin, G. J.; Taylor, H. M.; Hesser, F. H., and Rundles, R. W.: Clinical Evaluation of Complications Observed After Transthoracic Vagotomy , Arch. Surg. 55:175-179 ( (Aug.) ) 1947. 13. Bradley, W. F.; Small, J. T.; Wilson, J. W., and Walters, W.: Anatomic Considerations of Gastric Neurectomy , J. A. M. A. 133:459-461 ( (Feb. 15) ) 1947. 14. Machella, T. E.; Hodges, H. H., and Lorber, S. H.: The Restoration of Gastric Motility by Urethane or B-Methyl Choline After Section of the Vagus Nerves for Peptic Ulcer , Gastroenterology 8:36-51, 1947. 15. Wangensteen, O. H.: The Role of the Surgeon in the Management of Peptic Ulcer , New England J. Med. 236:191-196, 1947. 16. Walters, W.; Gray, H. K.; Priestley, J. T., and Counseller, V. S.: Annual Report on Surgery of the Stomach and Duodenum for 1942 , Proc. Staff Meet., Mayo Clin. 18:505-511, 1943. 17. Balfour, D. C.: Results of Gastro-Enterostomy for Ulcer of the Duodenum and Stomach , Ann. Surg. 92:558-562, 1930. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

EARLY AND DELAYED CLINICAL EFFECTS OF VAGOTOMY FOR PEPTIC ULCER

Archives of Surgery , Volume 59 (4) – Oct 1, 1949

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Publisher
American Medical Association
Copyright
Copyright © 1949 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1949.01240040823002
Publisher site
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Abstract

Abstract BETWEEN Nov. 1, 1946 and Nov. 1, 1947, vagus resection for treatment of peptic ulcer, as recently advocated by Dragstedt,1 was performed in 42 cases at the Veterans Administration General Hospital at Los Angeles (Sawtelle), Calif. All patients were operated on by surgeons of the joint graduate teaching service of the University of Southern California, College of Medical Evangelists, and the University of California at Los Angeles medical schools. The patients, all men, varied in age from 20 to 68 years, the average age being 47½ years. One or more of the classic indications for surgical intervention in treatment of peptic ulcer were present in all cases, namely, (1) chronicity with poor response to, or inability to carry out, an adequate medical regimen, (2) hemorrhage and (3) obstruction. The duration of symptoms varied from four months to twenty years, the average being 11.2 years. Recurrent or intractable pain was References 1. (a) Dragstedt, L. R., and Owens, F. M.: Supradiaphragmatic Section of Vagus Nerves in Treatment of Duodenal Ulcer , Proc. Soc. Exper. Biol. & Med. 53:152-154, 1943. 2. (b) Dragstedt, L. R., and Schafer, P. W.: Removal of the Vagus Innervation of the Stomach in Gastroduodenal Ulcer , Surgery 17:742-749, 1945. 3. (c) Dragstedt, L. R.: Vagotomy for Gastroduodenal Ulcer , Ann. Surg. 122:973-989, 1945. 4. Moore, F. D.: Resection of the Vagus Nerves for Ulcer: An Interim Evaluation , Arch. Surg. 55:164-174 ( (Aug.) ) 1947. 5. Moore, F. D.; Chapman, W. P.; Schulz, M. D., and Jones, C. M.: Transdiaphragmatic Resection of the Vagus Nerves for Peptic Ulcer , New England J. Med. 234:241-251, 1946 6. Vagus Resection in Peptic Ulcer: Physiologic Effects and Clinical Results , J. A. M. A. 133:741-759 ( (March 15) ) 1947. 7. Grimson, K. S.; Baylin, G. J.; Taylor, H. M.; Hesser, F. H., and Rundles, R. W.: Transthoracic Vagotomy: The Effects in Fifty-Seven Patients with Peptic Ulcer and the Clinical Limitations , J. A. M. A. 134:925-932 ( (July 12) ) 1947. 8. Crandell, W. B.; Boehm, W. E., and Mulholland, J. H.: Effects of Supradiaphragmatic Section of the Vagus Nerves in Man , Arch. Surg. 55:343-348 ( (Sept.) ) 1947. 9. Thornton, T. F., Jr.; Storer, E. H., and Dragstedt, L. R.: Supradiaphragmatic Section of the Vagus Nerves: Effect on Gastric Secretion and Motility in Patients with Peptic Ulcer , J. A. M. A. 130:764-771 ( (March 23) ) 1946. 10. Walters, W.; Neibling, H. A.; Bradley, W. F.; Small, J. T., and Wilson, J. W.: Gastric Neurectomy: Anatomic and Physiologic Studies with Favorable and Unfavorable Results in the Treatment of Peptic Ulcer , Arch. Surg. 55:151-163 ( (Aug.) ) 1947. 11. Walters, W.; Neibling, H. A.; Bradley, W. F.; Small, J. T., and Wilson, J. W.: Gastric Neurectomy for Gastric and Duodenal Ulceration: An Anatomic and Clinical Study , Ann. Surg. 126:1-18, 1947. 12. Grimson, K. S.; Baylin, G. J.; Taylor, H. M.; Hesser, F. H., and Rundles, R. W.: Clinical Evaluation of Complications Observed After Transthoracic Vagotomy , Arch. Surg. 55:175-179 ( (Aug.) ) 1947. 13. Bradley, W. F.; Small, J. T.; Wilson, J. W., and Walters, W.: Anatomic Considerations of Gastric Neurectomy , J. A. M. A. 133:459-461 ( (Feb. 15) ) 1947. 14. Machella, T. E.; Hodges, H. H., and Lorber, S. H.: The Restoration of Gastric Motility by Urethane or B-Methyl Choline After Section of the Vagus Nerves for Peptic Ulcer , Gastroenterology 8:36-51, 1947. 15. Wangensteen, O. H.: The Role of the Surgeon in the Management of Peptic Ulcer , New England J. Med. 236:191-196, 1947. 16. Walters, W.; Gray, H. K.; Priestley, J. T., and Counseller, V. S.: Annual Report on Surgery of the Stomach and Duodenum for 1942 , Proc. Staff Meet., Mayo Clin. 18:505-511, 1943. 17. Balfour, D. C.: Results of Gastro-Enterostomy for Ulcer of the Duodenum and Stomach , Ann. Surg. 92:558-562, 1930.

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1949

References