[Cancer of the operated stomach: a descriptive study on the experience of the last 12 years].

BACKGROUND

The incidence of gastric remnant carcinoma ranges between 1% and 9%. We report here our experience in a sanitary area in which, on account of different social and working reasons, the surgical indication for treatment of peptic disease was very common in previous decades.

PATIENTS AND METHODS

An analysis was made of the 52 cases of patients operated over the last 12 years, which represents 7.13% of 729 gastric cancers operated over the same time period.

RESULTS

In 67% of cases the carcinoma sat on a type-II stump, in 25% on a B-I type stump, and in the remaining 8% on stomachs with vagotomy and pyloroplasty. Seventy-five percent of patients had two characteristics: to be older than 60 years and to have undergone primary surgery at least 15 years before. Over half of patients were admitted on an emergency basis with no diagnosis and had received prolonged symptomatic therapies without previous examinations. The carcinoma involved the anastomotic mouth in 56% of cases and the histologic intestinal type predominated. Twenty-seven percent of patients had stages I and II, whereas almost half of patients had stage IV. Surgical resection was feasible in 42 cases (81%), with a surgical mortality rate of 21% for resections. The overall survival rate estimated at 5 years was 23%.

CONCLUSIONS

The possibility of performing surgery with a curative aim is the main prognostic factor for the gastric remnant carcinoma. The endoscopic study of patients at risk allows for diagnosis in earlier stages and therefore and improvement in results.