Vecchioni R, Rossi M
Istituto di Patologia Speciale Chirurgica e Propedeutica Clinica, Università di Verona.
Chir Ital. 1990 Feb-Apr;42(1-2):3-12.
The experienced gained over the past few years in the Verona University Institute of Surgical Pathology has revealed a slow, though progressive, increase in the number of gastric stump cancers, reflecting a trend emerging in the literature. There can be no doubt that an important factor in the enhanced detection of such cancers is the adoption of digestive endoscopy in routine clinical practice. Silent symptoms, barely noticeable clinical signs and the particular aggressiveness of the tumours often lead to an excessively late diagnosis, which, unfortunately, limits the efficacy of surgical therapy. We therefore recommend, as a single solution to the problem, the endoscopic screening of all patients who have undergone gastric resection ten or more years ago in order to detect early stump cancer. Obviously, and fortunately, in a few years time gastric stump cancer will be a rare phenomenon, in view of the exponential drop in gastric resections for ulcer disease over the past decade.
维罗纳大学外科病理研究所过去几年积累的经验表明,胃残端癌的数量虽增长缓慢,但呈上升趋势,这反映了文献中出现的一种趋势。毫无疑问,此类癌症检测增加的一个重要因素是消化内镜在常规临床实践中的应用。症状不明显、临床体征难以察觉以及肿瘤的特殊侵袭性常导致诊断过晚,不幸的是,这限制了手术治疗的效果。因此,我们建议,作为解决该问题的唯一办法,对所有在十年或更早之前接受过胃切除术的患者进行内镜筛查,以便检测早期残端癌。显然且幸运的是,鉴于过去十年因溃疡病进行胃切除术的数量呈指数下降,再过几年胃残端癌将成为一种罕见现象。