Screening of Helicobacter pylori Infection After Gastrectomy for Cancer or Peptic Ulcer

Giuliani, Andrea; Galati, Gaspare; Demoro, Martino; Scimò, Michele; Pecorella, Irene; Basso, L.

doi:10.1001/archsurg.2010.211

Cited by 12 publications

(8 citation statements)

References 47 publications

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“…Eradication therapy results in significant improvements in inflammation and atrophy of the mucosal layer in the remnant stomach after early gastric cancer surgery (21). These findings support the role of H. pylori in gastric carcinogenesis and suggest that H. pylori eradication therapy may prevent the development of metachronous gastric cancer after gastric resection (22).…”

Section: Introductionmentioning

confidence: 75%

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Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

et al. 2013

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Residual mucosa in the gastric stump after pylorus-preserving gastrectomy (PPG) is considered a risk factor for the development of gastric stump carcinoma (GSC). Duodenogastric reflux (DGR) and Helicobacter pylori (H. pylori) infection are suspected to contribute to the development of GSC. The aim of this study was to investigate the prevalence of H. pylori in the residual stomach after PPG for gastric cancer and to assess factors associated with the presence of H. pylori. We investigated 72 patients who had undergone PPG at least 1 year prior to the study and were confirmed to be positive for H. pylori infection on presurgical endoscopic biopsy. The extent of DGR, the prevalence of H. pylori infection based on H. pylori stool antigen (HpSA) tests and the severity of gastritis were analyzed in these post-PPG patients. None of the patients had DGR, as shown by (99m)Tc-PMT. Of the 72 post-PPG patients, 33 (46%) were positive for HpSA. The prevalence of H. pylori infection was significantly lower after surgery than before surgery. The endoscopic severity of remnant gastritis, as well as histological inflammation and activity, were higher in H. pylori-positive patients than in H. pylori-negative patients. In conclusion, some patients who undergo PPG and are negative for DGR experience spontaneous clearance of H. pylori infection.

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Section: Introductionmentioning

confidence: 75%

“…The presence of residual mucosa in the gastric stump is considered a risk factor for GSC, as well as a precancerous condition, independent of indications for surgery (22). Although there are more sensitive methods for detecting H. pylori, we assessed H. pylori infection status using stool HpSA tests.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

et al. 2013

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“…That is, Billroth-II procedure had a higher bile reflux rate and a lower H. pylori infection prevalence than the Billroth-I procedure 18. In contrast, there have been reports on H. pylori reinfection after partial gastrectomy in benign diseases,19 and the remnant mucosa after gastric resection for duodenal ulcer and gastric cancer was suggested to be a favorable environment for H. pylori infection 20. These various reports necessitate further investigation on the natural course of H. pylori status after gastric surgery.…”

Section: Discussionmentioning

confidence: 96%

Dynamic Changes inHelicobacter pyloriStatus Following Gastric Cancer Surgery

Yoon

Kim

et al. 2017

Gut and Liver

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Background/AimsHelicobacter pylori eradication is recommended in patients with early gastric cancer. However, the possibility of spontaneous regression raises a question for clinicians about the need for “retesting” postoperative H. pylori status.MethodsPatients who underwent curative gastrectomy at Seoul National University Bundang Hospital and had a positive H. pylori status without eradication therapy at the time of gastric cancer diagnosis were prospectively enrolled in this study. H. pylori status and atrophic gastritis (AG) and intestinal metaplasia (IM) histologic status were assessed pre- and postoperatively.ResultsOne hundred forty patients (mean age, 59.0 years; 60.7% male) underwent subtotal gastrectomy with B-I (65.0%), B-II (27.1%), Roux-en-Y (4.3%), jejunal interposition (0.7%), or proximal gastrectomy (4.3%). Preoperative presence of AG (62.9%) and IM (72.9%) was confirmed. The mean period between surgery and the last endoscopic follow-up was 38.0±25.6 months. Of the 140 patients, 80 (57.1%) were found to be persistently positive for H. pylori, and 60 (42.9%) showed spontaneous negative conversion at least once during follow-up. Of these 60 patients, eight (13.3%) showed more complex postoperative dynamic changes between negative and positive results. The spontaneous negative conversion group showed a trend of having more postoperative IM compared to the persistent H. pylori group.ConclusionsA high percentage of spontaneous regression and complex dynamic changes in H. pylori status were observed after partial gastrectomy, especially in individuals with postoperative histological IM. It is better to consider postoperative eradication therapy after retesting for H. pylori.

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“…Hp eradication therapy might prevent the development of metachronous gastric cancer. 26 Meanwhile, minimization of immunosuppressive therapy without compromising the protection to the transplanted liver or using new immunosuppressive agents with lower adverse effects might help in reducing the risk of a de novo neoplasm.…”

Section: Discussionmentioning

confidence: 99%

Lessons Learned From a Case of Gastric Cancer After Liver Transplantation for Hepatocellular Carcinoma

Yang¹,

Zhu²,

Chen³

et al. 2016

Medicine

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Nowadays, de novo malignancies have become an important cause of death after transplantation. According to the accumulation of cases with liver transplantation, the incidence of de novo gastric cancer is anticipated to increase among liver transplant recipients in the near future, especially in some East Asian countries where both liver diseases requiring liver transplantation and gastric cancer are major burdens. Unfortunately, there is limited information regarding the relationship between de novo gastric cancer and liver transplantation. Herein, we report a case of stage IIIc gastric cancer after liver transplantation for hepatocellular carcinoma, who was successfully treated by radical distal gastrectomy with D2 lymphadenectomy but died 15 months later due to tumor progression. Furthermore, we extract some lessons to learn from the case and review the literatures.The incidence of de novo gastric cancer following liver transplantations is increasing and higher than the general population. Doctors should be vigilant in early detection and control the risk factors causing de novo gastric cancer after liver transplantation. Curative gastrectomy with D2 lymphadenectomy is still the mainstay of treatment for such patients. Preoperative assessments, strict postoperative monitoring, and managements are mandatory. Limited chemotherapy could be given to the patients with high risk of recurrence. Close surveillance, early detection, and treatment of posttransplant cancers are extremely important and essential to improve the survival.

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Screening of Helicobacter pylori Infection After Gastrectomy for Cancer or Peptic Ulcer

Abstract: The results of this investigation support the role of HP in gastric carcinogenesis and suggest that the HP eradication therapy might prevent the development of metachronous gastric cancer after gastric resection.

Cited by 12 publications

References 47 publications

Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

Dynamic Changes inHelicobacter pyloriStatus Following Gastric Cancer Surgery

Lessons Learned From a Case of Gastric Cancer After Liver Transplantation for Hepatocellular Carcinoma

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