Experimentelles Anastomosencarcinom

Abstract

Experimental Anastomosing Carcinoma A Contribution to the Pathogenesis of Gastric Carcinoma after Stomach ResectionSummary. 66 male Wistar rats, subjected to gastric resection according to Billroth I or Billroth II and subsequently exposed to Nitrosoguanidine as oral carcinogen, developed carcinomas and precancerous lesions at a rate of 65,1%. The tumours were characterized histologically as adenocarcinomas; they were almost exclusively localized in the region of the gastroduodenal or gastrojcjunal anastomosis. The process of cancer development was completed within 17 to 31 weeks on continous administration of 120 mg/lofNitrosoguanidine in the drinking water. 34 control animals either with intact stomachs subjected to the carcinogen or operated and kept under normal drinking water showed no cancer formation. Only one precancerous lesion (adenomatous hyperplasia) could be observed in the control group with intact stomachs.Trying to relate the present findings to the occurrence of gastric stump carcinoma in man the following conclusions can be made: 1. The operated stomach is predilected for cancer development. 2. Exposure of the operated stomach to an oral carcinogen induces carcinogenesis prevalent in the anastomotic region.

Operation‐sequel carcinoma of the stomach. Experimental studies of surgical techniques with or without resection

“…The teams using surgical resection also obtained dissimilar results in spite of their apparently similar experimental conditions, probably due to the differing surgical techniques. These authors emphasized the importance of duodenogastric reflux as an etiopathogenetic factor [5][6][7]. However, an assay that compares not more than 3 groups with insufficient variations of reflux intensity appears inadequate to prove a direct correlation of duodenogastric reflux with carcinoma incidence or frequency.…”

“…However, an assay that compares not more than 3 groups with insufficient variations of reflux intensity appears inadequate to prove a direct correlation of duodenogastric reflux with carcinoma incidence or frequency. The only experimental set-up designed for carcinoma induction without carcinogen application failed to yield convincing results, probably on account of its limited duration [5].…”

“…Differing rates of carcinoma incidence with or without carcinogen exposure were a somewhat surprising result of the present study. Dahm and Werner [5] had found no tumors after BI or BII resection, but the incidence rates after application of MNNG at a dosage of 120 mg/L were 40.5% or 34.5%, respectively. The tumor yield in our assay was approximately the same with and without carcinogen application, and similarly dependent on the resection techniques used in the different groups.…”

Tierexperimentelle untersuchungen zur karzinogeninduzierten tumorbildung an kolotomien in abh�ngigkeit von nahtmaterialien

“…Gesichert ist, dab nach Magenresektionen als Sp/itf.olge h/iufig Karzinome an der Anastomose entstehen [9]. Uber autochthone Tumoren nach Teilresektionen des Darmes, die aufgrund benigner Erkrankungen durchgeffihrt wurden, liegt zwar noch keine Literatur vor, jedoch finden sich Angaben, wonach die Anatomose nach Resektionen von malignen Darmtumore iiberzuffillig h/iufig Sitz eines lokalen Rezidives ist [19].…”

Predisposition of the resected stomach for malignancy

“…Cancer of the gastric stump following resection for benign ulcer disease emerges after the so-called free interval of at least 5 years [4]. With the majority of patients, however, this interval is 20 to 30 years [5][6][7].…”