Issever Kubilay, Kuloglu Ersin, Sengul Demet, Muhtaroglu Ali, Dulger Ahmet Cumhur
Internal Medicine, Giresun University Faculty of Medicine, Giresun, TUR.
Pathology, Giresun University Faculty of Medicine, Giresun, TUR.
Cureus. 2023 Aug 5;15(8):e42976. doi: 10.7759/cureus.42976. eCollection 2023 Aug.
Aims and objectives Distal gastrectomy was a widely used therapeutic option for peptic ulcer and gastroesophageal reflux disease until quite recently. The consequences of anatomical and physiological changes following surgery in the gastric mucosa have been the object of interest for the scientist. In this study, we aimed to determine whether Helicobacter pylori (HP) infection and celiac disease were more common in patients with a history of distal gastrectomy. Materials and methods This is an observational retrospective study conducted at Giresun University Faculty of Medicine. The medical files of 35 patients with dyspepsia who had a history of distal gastrectomy for benign etiologies (antrectomy group) and 50 patients with dyspepsia (control group) were retrospectively analyzed. Results There were more males and older patients in the antrectomy group. Concerning the lab parameters, platelets, lymphocyte, and albumin levels were significantly lower, and urea, creatinine, anti-Endomisium Ig A (anti-EMA), and anti-tissue transglutaminase IgA (anti-tTGA) antibody positivity were significantly higher in the antrectomy group. Gastric biopsy results revealed a higher positivity of HP, atrophy, neutrophil, and lymphocytes in the antrectomy group. Correlation analysis revealed an inverse correlation between albumin and anti-EMA/atrophy positivity whereas a positive correlation between anti-EMA and HP/atrophy positivity. Conclusions HP infection and coeliac disease (CD) could be the problems that distal gastrectomy patients with dyspepsia can face during their follow-up. Concerning the pre-malignant potential of HP, its screening and eradication should be performed to prevent the malignant transformation of the remnant gastric tissue.
目的 直到最近,远端胃切除术一直是消化性溃疡和胃食管反流病广泛使用的治疗选择。胃黏膜手术后解剖学和生理学变化的后果一直是科学家们感兴趣的对象。在本研究中,我们旨在确定幽门螺杆菌(HP)感染和乳糜泻在有远端胃切除术病史的患者中是否更常见。
材料与方法 这是一项在吉雷松大学医学院进行的观察性回顾性研究。回顾性分析了35例因良性病因接受远端胃切除术的消化不良患者(胃窦切除术组)和50例消化不良患者(对照组)的病历。
结果 胃窦切除术组男性和老年患者更多。关于实验室参数,胃窦切除术组的血小板、淋巴细胞和白蛋白水平显著降低,而尿素、肌酐、抗肌内膜IgA(抗EMA)和抗组织转谷氨酰胺酶IgA(抗tTGA)抗体阳性率显著更高。胃活检结果显示胃窦切除术组HP、萎缩、中性粒细胞和淋巴细胞的阳性率更高。相关性分析显示白蛋白与抗EMA/萎缩阳性之间呈负相关,而抗EMA与HP/萎缩阳性之间呈正相关。
结论 HP感染和乳糜泻(CD)可能是有消化不良病史的远端胃切除术患者在随访期间可能面临的问题。鉴于HP的癌前潜能,应进行筛查和根除以防止残余胃组织的恶性转化。