Studies on Carcinoma of the Stomach after Gastric Surgery A Review of 10 Cases
Ten cases of carcinoma of the stomach after gastric surgery were examined. The average age of cases was 56.9 and the sex of them was predominantly male. Diagnosis of initial surgery were benign gastric disease (5 cases) and gastric carcinoma (5 cases). Billroth-II method without Braun anastmosis was...
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| Published in | Japanese Journal of National Medical Services Vol. 43; no. 3; pp. 277 - 284 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
Japanese Society of National Medical Services
1989
一般社団法人 国立医療学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-1699 1884-8729 |
| DOI | 10.11261/iryo1946.43.277 |
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| Abstract | Ten cases of carcinoma of the stomach after gastric surgery were examined. The average age of cases was 56.9 and the sex of them was predominantly male. Diagnosis of initial surgery were benign gastric disease (5 cases) and gastric carcinoma (5 cases). Billroth-II method without Braun anastmosis was chosen mainly for initial gastrectomy. The average interval between initial and subsequent surgery was 14.4 years in the cases of benign gastric diseases and 9.4 years in gastric carcinoma. Symptoms such as swallowing disturbances and epigastralgia were frequently seen in advanced carcinoma of the remnant stomach. Early stage of carcinoma was diagnosed by endoscope and biopsy. The methods of second operation were total resection of the remnant stomach (7 cases) and palliative surgery (3 cases): 5 cases underwent curative resection and 2 noncurative resection. Since the carcinoma of the remnant stomach was advanced, combined resection of spleen and/or tail of the pancreas was often done. Carcinomas of the resected remnant stomach were 3 early carcinomas (2 cases of type IIa, one type IIa+IIc) and 4 advanced carcinomas (2 cases of Borrmann 3, 2 cases of Borrmann 4). Cases of the curative resection survived three years and one month longer. Most of the noncurative cases and palliative surgery cases died in a year. Histologic examination of the resected remnant stomach revealed mild atrophic gastritis (all cases) and moderate intestinal metaplasia (a few cases) which were said to be precancerous changes. We conclude that several factors to improve the prognosis of surgery for carcinoma of the remnant stomach are as follows: 1) periodic follow-up and examination of diagnosis of early stage of cancer 2) total resection of the remnant stomach with combined resection of adjacent organs for complete lymphnode dissection. |
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| AbstractList | Ten cases of carcinoma of the stomach after gastric surgery were examined. The average age of cases was 56.9 and the sex of them was predominantly male. Diagnosis of initial surgery were benign gastric disease (5 cases) and gastric carcinoma (5 cases). Billroth-II method without Braun anastmosis was chosen mainly for initial gastrectomy. The average interval between initial and subsequent surgery was 14.4 years in the cases of benign gastric diseases and 9.4 years in gastric carcinoma. Symptoms such as swallowing disturbances and epigastralgia were frequently seen in advanced carcinoma of the remnant stomach. Early stage of carcinoma was diagnosed by endoscope and biopsy. The methods of second operation were total resection of the remnant stomach (7 cases) and palliative surgery (3 cases): 5 cases underwent curative resection and 2 noncurative resection. Since the carcinoma of the remnant stomach was advanced, combined resection of spleen and/or tail of the pancreas was often done. Carcinomas of the resected remnant stomach were 3 early carcinomas (2 cases of type IIa, one type IIa+IIc) and 4 advanced carcinomas (2 cases of Borrmann 3, 2 cases of Borrmann 4). Cases of the curative resection survived three years and one month longer. Most of the noncurative cases and palliative surgery cases died in a year. Histologic examination of the resected remnant stomach revealed mild atrophic gastritis (all cases) and moderate intestinal metaplasia (a few cases) which were said to be precancerous changes. We conclude that several factors to improve the prognosis of surgery for carcinoma of the remnant stomach are as follows: 1) periodic follow-up and examination of diagnosis of early stage of cancer 2) total resection of the remnant stomach with combined resection of adjacent organs for complete lymphnode dissection.
残胃の癌10例を城所の提唱する分類に当てはめると, 初回良性・悪性に関係なく10年以上たつて発見された残胃癌は6例, 10年以下であるが, 初回の病変と無関係に発生したと考えられる残胃癌は2例, 初回胃癌で胃切後10年以内に吻合口あるいは縫合線上に発見された残胃再発癌は2例であつた. 平均年令は56.9才, 男性に多く, 初回手術時の診断は良性疾患5例と胃癌5例で, ブラウン吻合(-)のBillroth-II法が多く行われた. 再手術までの期間は初回良性の方が長かつた. 早期癌は内視鏡検査でのみ確診可能であつた. 残胃全摘が7例に行われ, 脾など周囲臓器合併切除が行われたものが多かつた. 切除例中早期癌は3例, 進行癌4例で, 治癒切除例は3年1ヵ月以上生存した. 初回胃切除後より厳重な経過観察を行い, 早期癌の発見に努めるとともに, 積極的な外科切除を行えば, 残胃の癌も手術成績を向上させうるとおもわれる. Ten cases of carcinoma of the stomach after gastric surgery were examined. The average age of cases was 56.9 and the sex of them was predominantly male. Diagnosis of initial surgery were benign gastric disease (5 cases) and gastric carcinoma (5 cases). Billroth-II method without Braun anastmosis was chosen mainly for initial gastrectomy. The average interval between initial and subsequent surgery was 14.4 years in the cases of benign gastric diseases and 9.4 years in gastric carcinoma. Symptoms such as swallowing disturbances and epigastralgia were frequently seen in advanced carcinoma of the remnant stomach. Early stage of carcinoma was diagnosed by endoscope and biopsy. The methods of second operation were total resection of the remnant stomach (7 cases) and palliative surgery (3 cases): 5 cases underwent curative resection and 2 noncurative resection. Since the carcinoma of the remnant stomach was advanced, combined resection of spleen and/or tail of the pancreas was often done. Carcinomas of the resected remnant stomach were 3 early carcinomas (2 cases of type IIa, one type IIa+IIc) and 4 advanced carcinomas (2 cases of Borrmann 3, 2 cases of Borrmann 4). Cases of the curative resection survived three years and one month longer. Most of the noncurative cases and palliative surgery cases died in a year. Histologic examination of the resected remnant stomach revealed mild atrophic gastritis (all cases) and moderate intestinal metaplasia (a few cases) which were said to be precancerous changes. We conclude that several factors to improve the prognosis of surgery for carcinoma of the remnant stomach are as follows: 1) periodic follow-up and examination of diagnosis of early stage of cancer 2) total resection of the remnant stomach with combined resection of adjacent organs for complete lymphnode dissection. |
| Author | TANAKA, Toshiaki TANEMOTO, Kazuo OOISHI, Masahiro SASAKI, Akira YAMASHITA, Hiroshi KONAGA, Eiji TAKEUCHI, Hitoshi KOBAYASHI, Genso |
| Author_FL | 小林 元壮 小長 英二 田中 寿明 種本 和雄 山下 博士 竹内 仁司 佐々木 明 大石 正博 |
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| DocumentTitleAlternate | A Review of 10 Cases 自験10例を中心としての考察 残胃の癌の検討 自験１０例を中心としての考察 |
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| References | 1) 城所仂: 残胃の癌切除例の遠隔成績, ―胃癌研究会98施設613例の検討―. 日癌治 17, 55, 1982 15) 曽和融生, 加藤保之, 大北日吉他: 残胃の癌の検討―自験28例を中心としての考察―. 日消外会誌 17, 15, 1984 16) 山田達哉, 水口安則, 縄野繁他: 残胃の癌の早期診断. 外科 49, 668, 1987 13) Kondo K, Suzuki H, Nagayo T: The influence of gastro-jejunal anastmosis on gastric carcinogenesis in rats. Gann 75, 362, 1984 21) Koga S, Watanabe H, Enjoji M: Stomal polypoid hypertrophic gastritis. A polypoid gastric lesion at gastroenterostomy site. Cancer 43, 647, 1979 11) Asano A et al: The long-term prognosis of patients gastrectomized for benign gastroduodenal diseases. Jpn J Cancer Res (Gann) 78, 337, 1987 17) 吉野肇一, 熊井浩一郎, 杉野吉則: 残胃の癌の早期診断. 外科治療 57, 271, 1987 20) 高木國夫, 太田博俊, 高橋知之他: 残胃癌の治療. 外科 49, 684, 1987 14) 榊原幸雄: 残胃の癌の問題点. 外科 49, 651, 1987 6) 島津久明, 小堀鴎一郎, 保坂茂文他: 残胃初発癌症例に関する検討. 日消外会誌 12, 713, 1979 8) Stalsberg H, Taksdal S: Stomach cancer following gastric surgery for benign conditions. Lancet 2, 1175, 1971 12) 徳留信寛: 残胃の癌の疫学. 外科 49, 656, 1987 3) 村上忠重, 戸部勇: 吻合部癌の症例報告. 外科治療 12, 1, 1965 10) 徳留信寛, 古野純典, 池田正人他: 胃・十二指腸の良性疾患に対する胃切除後の残胃初発癌. 胃と腸 17, 1295, 1982 4) 藤田吉四郎, 伊藤一二, 三輪潔他: 残胃の癌27例の外科的検討. 外科 31, 919, 1969 7) 岡島邦雄, 山田真一, 磯崎博司: 「残胃癌」の検討―進行度因子の検討と予後―. 消外 8, 61, 1985 19) 鈴木博孝, 遠藤光夫, 小林誠一郎他: 残胃の癌の手術治療と予後の検討. 胃と腸 17, 1313, 1982 2) 城所仂, 林田康男: 残胃の癌と「残胃癌」―その定義と臨床像―. 消外 8, 31, 1985 18) 古河洋, 岩永剛, 平塚正弘他: 臨床病理からみた残胃の癌の発生. 消外 8, 43, 1985 5) “残胃の癌”をめぐつて (座談会). 胃と腸 17, 1366, 1982 9) Caygill CPJ et al: Mortality from gastric cancer following gastric surgery for peptic ulcer. Lancet 1, 929, 1986 |
| References_xml | – reference: 7) 岡島邦雄, 山田真一, 磯崎博司: 「残胃癌」の検討―進行度因子の検討と予後―. 消外 8, 61, 1985 – reference: 18) 古河洋, 岩永剛, 平塚正弘他: 臨床病理からみた残胃の癌の発生. 消外 8, 43, 1985 – reference: 15) 曽和融生, 加藤保之, 大北日吉他: 残胃の癌の検討―自験28例を中心としての考察―. 日消外会誌 17, 15, 1984 – reference: 13) Kondo K, Suzuki H, Nagayo T: The influence of gastro-jejunal anastmosis on gastric carcinogenesis in rats. Gann 75, 362, 1984 – reference: 1) 城所仂: 残胃の癌切除例の遠隔成績, ―胃癌研究会98施設613例の検討―. 日癌治 17, 55, 1982 – reference: 14) 榊原幸雄: 残胃の癌の問題点. 外科 49, 651, 1987 – reference: 8) Stalsberg H, Taksdal S: Stomach cancer following gastric surgery for benign conditions. Lancet 2, 1175, 1971 – reference: 2) 城所仂, 林田康男: 残胃の癌と「残胃癌」―その定義と臨床像―. 消外 8, 31, 1985 – reference: 9) Caygill CPJ et al: Mortality from gastric cancer following gastric surgery for peptic ulcer. Lancet 1, 929, 1986 – reference: 10) 徳留信寛, 古野純典, 池田正人他: 胃・十二指腸の良性疾患に対する胃切除後の残胃初発癌. 胃と腸 17, 1295, 1982 – reference: 21) Koga S, Watanabe H, Enjoji M: Stomal polypoid hypertrophic gastritis. A polypoid gastric lesion at gastroenterostomy site. Cancer 43, 647, 1979 – reference: 6) 島津久明, 小堀鴎一郎, 保坂茂文他: 残胃初発癌症例に関する検討. 日消外会誌 12, 713, 1979 – reference: 20) 高木國夫, 太田博俊, 高橋知之他: 残胃癌の治療. 外科 49, 684, 1987 – reference: 19) 鈴木博孝, 遠藤光夫, 小林誠一郎他: 残胃の癌の手術治療と予後の検討. 胃と腸 17, 1313, 1982 – reference: 5) “残胃の癌”をめぐつて (座談会). 胃と腸 17, 1366, 1982 – reference: 12) 徳留信寛: 残胃の癌の疫学. 外科 49, 656, 1987 – reference: 3) 村上忠重, 戸部勇: 吻合部癌の症例報告. 外科治療 12, 1, 1965 – reference: 17) 吉野肇一, 熊井浩一郎, 杉野吉則: 残胃の癌の早期診断. 外科治療 57, 271, 1987 – reference: 16) 山田達哉, 水口安則, 縄野繁他: 残胃の癌の早期診断. 外科 49, 668, 1987 – reference: 4) 藤田吉四郎, 伊藤一二, 三輪潔他: 残胃の癌27例の外科的検討. 外科 31, 919, 1969 – reference: 11) Asano A et al: The long-term prognosis of patients gastrectomized for benign gastroduodenal diseases. Jpn J Cancer Res (Gann) 78, 337, 1987 |
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| Subtitle | A Review of 10 Cases |
| Title | Studies on Carcinoma of the Stomach after Gastric Surgery |
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