Schlag P, Weber E, Meister H, Meyer H
Langenbecks Arch Chir. 1982;357(2):105-16. doi: 10.1007/BF01237456.
To assess the possible risk of cancer in the operated stomach, the influence of truncal vagotomy combined with different operative drainage procedures (pyloroplasty, gastro-enterostomy without entero-anastomosis, Roux-en-Y gastro-enterostomy) was studied in animal experiments. The aim of the study was to determine whether, compared to controls an earlier and higher incidence of precancerous epithelial lesions or cancers in the stomach occurs in vagotomized animals after oral administration of carcinogens (MNNG). To consider conditions, that may predispose to in vivo formation of carcinogenic N-nitroso compounds, bacterial flora and intragastric nitrite concentration were measured and compared in the various operative groups. The severity of induced epithelial lesions and the quantity of bacterial growth and nitrite concentration in the gastric juice were influenced, apart from the reduction of acid output after vagotomy, mainly by prolonged gastric stasis or the degree of enterogastric reflux. The results suggest that there is probably no increased risk of cancer following vagotomy, if sufficient gastric clearance is guaranteed and enterogastric reflux is largely excluded.
为评估手术胃发生癌症的潜在风险,在动物实验中研究了迷走神经干切断术联合不同手术引流程序(幽门成形术、无肠吻合的胃肠吻合术、Roux-en-Y胃肠吻合术)的影响。本研究的目的是确定与对照组相比,在口服致癌物(MNNG)后,迷走神经切断的动物胃中癌前上皮病变或癌症的发生率是否更早且更高。为考虑可能易导致体内致癌性N-亚硝基化合物形成的条件,在各个手术组中测量并比较了细菌菌群和胃内亚硝酸盐浓度。除迷走神经切断术后胃酸分泌减少外,诱导的上皮病变严重程度以及胃液中细菌生长量和亚硝酸盐浓度主要受胃排空延长或肠胃反流程度的影响。结果表明,如果保证足够的胃排空并基本排除肠胃反流,迷走神经切断术后发生癌症的风险可能不会增加。