Predisposition of the resected stomach for malignancy

Abstract

During the 20‐year period from 1959 to 1978, a total of 62 cases of cancer of the gastric stump following gastric resection for benign peptic ulcer were studied in relation to the occurrence of gastric primary carcinoma. This group was compared with the group of patients who were operated on for peptic disease during the same period. Cancer of the gastric stump constituted 4.6% of all gastric carcinomas. The relation between the number of operations for gastric stump carcinomas and the number of gastric resections for benign conditions, performed during the same period, makes the relative frequency 2.6%. The average free interval of 21 years was established to have elapsed from gastric resection to the confirmed diagnosis of malignancy of the stump. The symptoms of anemia, weight loss, and dysphagia were the most frequent presenting complaints. All 62 patients with cancer of the gastric stump were operated on: 20 exploratory, 16 palliative procedures, and 26 curative total gastric resections. The results were poor, mostly due to the late diagnosis. The importance of frequent follow‐up examinations by radiology and endoscopy of the patients having been subjected to gastric resection is emphasized.

Chromoendoscopic Evaluation of Gastric Mucosa after Partial Gastrectomy by Use of Modified Endoscopic Congo Red Test

“…This cancer rate is significantly higher than that expected from a comparable population [18]. Periodic screening for stump cancer at 15–20 years after partial gastrectomy has been proposed by many investigators [8, 24, 26, 31, 32], but large‐scale screening has not been recommended on the basis of the low cost‐effectiveness of routine endoscopy [4, 33, 34, 35]. Considering the strong relationship between gastric cancer on one hand, and achlorhydria [11, 36, 37], and severity and extension of CAFG in the nonoperated stomach [14] on the other hand, it may be suggested that MCRT, unlike routine gastroscopy, may be cost‐effective in selecting high‐risk patients for screening, especially in light of the fact that patients with early gastric stump cancer have en excellent prognosis [24, 38].…”