SU1296120A1 - Method of determining completeness of vagotomy in time of operation - Google Patents

Abstract

In order to improve the accuracy and speed up the method of determining the completeness of vagotomy during surgery for duodenal ulcer, platinum electrodes are placed subserously in the body, bottom and cardiac regions of the stomach. After 3-5 minutes, the magnitude of the redox potential (ORP) in these areas is measured. After stem or selective proximal vagotomy, the ORP is measured again. With a decrease in AFP of less than 70 mV, the vagotomy is considered complete.

Description

one

The invention relates to medicine, namely to surgery, and can be used to determine the completeness of vagotomy during surgery in patients with duodenal ulcer.

The purpose of the invention is to increase the accuracy and speed up the method of determining the completeness of vagotomy during surgery,

The goal is achieved by taking potentiometric measurements from the external wall of the stomach (serosa) before and after vagotomy.

The method is carried out as follows.

In patients during surgery for duodenal ulcer disease under intubation anesthesia (with the exception of the introduction of atropine and metacin), platinum electrodes are placed subserously in the areas of the body, bottom and cardiac compartment of the stomach. Chalcalium agar-agar bridges, running through ctr reference electrodes, are attached to the forearm. Three to five minutes after the subserous administration of the platinum electrode, the magnitude of the oxidative reduction potential (SSB) is measured in three areas of the stomach. After the main stage of the operation - stem or selective proximal vagotomy, the magnitude of the AFP is again measured at the same points in the areas of the body, bottom and cardiac part of the stomach. If the AFP is reduced in these areas by at least 70 mV, they consider the vagotomy to be complete.

Example 1, Patient B. On the basis of complaints, anamnesis, objective and laboratory data, x-ray and fibrogastroscopic examination, as well as intragastric pH-meter, the following diagnosis was made: chronic duodenal ulcer. On January 8, 1985, an operation was performed - laparotomy, proximally selective agotome. During the operation, a pH probe with antral and corpus pH-olivago was introduced into the stomach through the mouth to measure the pH of the gastric mucosa. ORP is measured using a platinum electrode inserted subserosally in the body, bottom and cardiac regions of the stomach. PH values before vagotomy

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the body, the bottom and the cardiac section of the stomach are respectively 4.6; 45.4; 3.6. The ORP values from the serous membrane in the same areas of the stomach are respectively 70-40 and 80 mV. After the vagotomy, the AFP values at the same points of the corresponding regions of the stomach are 280-190 and 190 mV. After vagotomy, a decrease in the amount of AFP is observed in the body by 210 mV, in the bottom - by 150 mV, and in the cardiac part of the stomach - by 110 mV. After vagotomy on the background of stimulated secretion with 0.1% hydrochloric acid histamine 0.01 µg / hg, the pH values are respectively in sections 5.3; 6.1; 5.8, which indicates a valid submission of the acid-producing function. The postoperative period is uneventful. The clinical examination performed, fibrogastroduodenoscopy data in the immediate post-operative period, show a decrease in ulcers and a decrease in the acid-forming function of the stomach.

PRI mme R 2. Patient T. On the basis of complaints, anamnesis, objective and laboratory data, x-ray and fibrogastroscopic examinations, as well as intragastric pH-metry, a diagnosis was made: chronic duodenal ulcer. The operation was performed - laparotomy, proximal selective vagotomy with Jabulei ororoplasty. The values of the AFP before vagotomy in the body, the bottom and the cardiac section of the stomach were 560, 540 and 560 mV, and after vagotomy decreased by 100, 70 and 100 mV, respectively, on the basis of which they conclude that vagotomy is complete. The correctness of the withdrawal is confirmed by pH measurements, the values of which after vagotomy increase from 5.0; 5.7 and 4.8 to 8.6; 8.7 and 8.9 respectively. This example illustrates the lower limit of the proposed criterion - 70 mV. The postoperative period is without complications. Carried out

clinical examination, data of fibrogastroduodenoscopy and intra-gastric pH-metry in the nearest (14 days) postoperative period show healing of ulcers and a decrease in the acid-forming function of the stomach; compared with the preoperative data.

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The method allows to exclude the use of u and so that, in order to increase the maximum histamine accuracy and speed up the method, the test during the operation. Measure the redox potential from the side of the sero form of the invention of the 5 th shell in the body , the bottom and the cardiac section of the stomach before and after using the method for determining the fullness of vagotomy of vagotomy, and when reducing the mission during the operation, including the magnitude of oxidation-reduction and potentiometric measurement potential of not less than the wall of the stomach, o tl and h a- O 70 mV, determines the completeness of vagotomy.

Claims (1)

The claims 5 A method for determining the completeness of vagotomy during surgery, including potentiometric measurements in the wall of the stomach, about t l and h a-K 20 4 with the fact that, in order to increase the accuracy and speed up the method, the redox potential of the serous membrane in the body, bottom and cardiac section of the stomach is measured before and after vagotomy, and with a decrease in the value of redox potential of not less than 70 mV determine the completeness of vagotomy. Compiled by E. Kolmakova Editor E. Sligan Tehred I.Popovich Corrector V. Butyaga Order 644/5 VNIIIPI Circulation 596 Subscription USSR State Committee for inventions and discoveries 113035, Moscow, Zh-35, Raushskaya nab., 4/5 Production and printing company, Uzhgorod, Project 4,