Aste H, Molinari F, Raiteri G
Tumori. 1976 Jan-Feb;62(1):1-6. doi: 10.1177/030089167606200101.
33 cases of cancer of the gastric stump after gastrectomy for peptic ulcer observed between 1963 and 1972 are reviewed. In 26 patients the average interval between operation and carcinoma detection was over 20 years. No cases of carcinoma occurred in less than 10 years. All patients came too late for surgery, since they had attributed their symptoms to the previous operation. The gradual increase in the gastric-cancer risk of operated patients with time suggests a continuous carcinogenic influence. Regurgitation of duodenal contents through the Billroth II anastomosis seems to be the most important cause of postoperative atrophic gastritis, which is now considered by many authors to be a condition predisposing to gastric cancer. Gastric resection patients should be regarded as a high gastric-cancer risk group. The periodic use of modern procedures for early gastric cancer detection in this group of patients is therefore justified.
回顾了1963年至1972年间观察到的33例因消化性溃疡行胃切除术后残胃癌病例。26例患者手术与癌症检测之间的平均间隔超过20年。10年内无癌症病例发生。所有患者就诊时手术时机均已过晚,因为他们将症状归因于先前的手术。手术患者患胃癌的风险随时间逐渐增加,提示存在持续的致癌影响。十二指肠内容物通过毕罗Ⅱ式吻合口反流似乎是术后萎缩性胃炎的最重要原因,现在许多作者认为这是一种易患胃癌的情况。胃切除患者应被视为胃癌高危人群。因此,定期使用现代方法对该组患者进行早期胃癌检测是合理的。