Kaibara N, Nishidoi H, Yurugi E, Ikeguchi M, Makino M, Kawasumi H, Wakatsuki T, Koga S
Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 2):1523-7.
Experimental and clinical studies were undertaken to examine whether carcinogenesis in particular organs is influenced by types of surgical operations resulting in an alteration of bile acid excretion and metabolism. A higher incidence of remnant gastric carcinoma was noted in rats receiving gastrectomy with a greater amount of duodenogastric reflux. Furthermore, carcinogenesis was enhanced in gastrectomized rats that had been fed on a high-cholesterol diet causing an increase in bile acid excretion. In a human study, however, there was no relationship between gastrectomy and the incidence of remnant stomach carcinoma. Intestinal surgery alters bile acid metabolism, which may promote colon carcinogenesis. In patients receiving ileocecal resection or right hemicolectomy, the amount of total fecal bile acids was markedly increased as compared to the normal controls. A retrospective study on the incidence of metachronous colorectal cancer in our department showed that the incidence was 12.2% in patients with ileocecal resection in contrast to 4.4% in those with left-side colon resection. These findings suggest that there is a relationship between previous ileocecal resection and the development of metachronous colon carcinoma. We could not obtain any evidence of cholecystectomy having an increased risk for the development of colorectal carcinoma.
开展了实验和临床研究，以检验特定器官的致癌作用是否受导致胆汁酸排泄和代谢改变的手术类型影响。在接受十二指肠胃反流较多的胃切除术的大鼠中，残胃癌的发生率较高。此外，在喂食高胆固醇饮食导致胆汁酸排泄增加的胃切除大鼠中，致癌作用增强。然而，在一项人体研究中，胃切除术与残胃癌的发生率之间没有关联。肠道手术会改变胆汁酸代谢，这可能会促进结肠癌的发生。在接受回盲部切除术或右半结肠切除术的患者中，与正常对照组相比，粪便中总胆汁酸的量显著增加。对我科异时性结直肠癌发生率的一项回顾性研究表明，回盲部切除术患者的发生率为12.2%，而左侧结肠切除术患者为4.4%。这些发现表明，既往回盲部切除术与异时性结肠癌的发生之间存在关联。我们没有获得任何证据表明胆囊切除术会增加患结直肠癌的风险。
