Falter E, Preac-Mursic V, Hellerer O, Brückner W L
Z Gastroenterol. 1982 Jan;20(1):33-9.
Studies on why there is a higher disposition of carcinoma developing in the residual portion of the stomach of patients having undergone resections have led to the assumption that bacterial colonization constitutes a co-carcinogenic factor. It has been the purpose of this investigation to compare the ensuing bacterial growth following resective and nonresective stomach surgery. 120 Sprague-Dawley rats were divided into six groups: 1) control group: laparotomy. (2)SPV: with assured preservation of the antrum innervation. 3) SPV + Pypl.: the pyloroplasty was performed according to the Heinecke-upsilon. Mikulicz method. 4) TV + Pypl.: abdominal severance of the trunci nervi vagi. 5) BII: antecolonic without enteroanastomosis. 6) TV + BII. Eight months postoperative a smear was obtained under general anaesthesia from the transition segment between the fundus and antrum or at the site of the anastomosis. Tests for aerobic and anaerobic bacteria as well as cultures for fungi were begun. The control and SPV + Pypl. groups did not differ significantly in total bacteria count and in the ratio of nitrobacter. In contrast, the SPV group without pyloroplasty displayed an approximately tenfold higher concentration of nitrobacters--an amount equivalent to the sum of nitrobacters in the two resection techniques. The TV + BII group had a threefold higher total bacteria count than the BII group. According to our studies, a reduced stomach acid production, the bile secretion reflux and more importantly, a retarded food passage promote intragastric bacterial growth thus expediting the formation of intragastric carcinogenic nitrosamines.
对接受过胃部切除手术的患者胃残余部分为何更易发生癌变的研究,引发了细菌定植构成协同致癌因素这一假设。本研究的目的是比较切除性和非切除性胃部手术后随之发生的细菌生长情况。120只斯普拉格-道利大鼠被分为六组:1)对照组:剖腹术。(2)保留胃窦神经支配组(SPV)。3)SPV + 幽门成形术组:根据海涅克-米库利奇法进行幽门成形术。4)迷走神经干切断术 + 幽门成形术组(TV + Pypl.):迷走神经干腹部切断术。5)毕Ⅱ式:结肠前吻合无肠吻合术。6)TV + 毕Ⅱ式。术后八个月,在全身麻醉下从胃底与胃窦之间的过渡段或吻合部位获取涂片。开始进行需氧菌和厌氧菌检测以及真菌培养。对照组和SPV + 幽门成形术组在细菌总数和硝化细菌比例方面无显著差异。相比之下,未进行幽门成形术的SPV组硝化细菌浓度高出约十倍——这一数量相当于两种切除技术中硝化细菌数量之和。TV + 毕Ⅱ式组的细菌总数比毕Ⅱ式组高三倍。根据我们的研究,胃酸分泌减少、胆汁分泌反流,更重要的是食物通过受阻,会促进胃内细菌生长,从而加速胃内致癌亚硝胺的形成。