Summary
Between 1959 and 1987, at the Innsbruck University Hospital, 359 cases of carcinoma
were diagnosed in the gastric remnant. While until 1975 in 203 patients suffering
from stump carcinoma the tumor stages T3 and T4 were significantly prevalent, a strong
tendency towards the less advanced tumor stages T1 and T2 was observed in the last
decade. Among 94 patients operated on since 1981 the tumor was located at the anastomosis
in all but 5 cases, suggesting a strong connection between previous resection and
stump carcinoma. In accordance with Lauren's classification no difference was found
in the incidence of intestinal and diffuse lesions in 94 cases with stump carcinoma
- in contrast to 69 cases of patients with a non-resected stomach. An analysis of
the occurrence of acidity, atrophic gastritis and bacterial invasion in 70 patients
with previous Billroth II resection and 30 patients with Billroth I resection, revealed
no difference between the two types of resection. Gastric remnant carcinoma does not
occur exclusively in the Billroth II remnant, but, increasingly, following Billroth
I operations. The finding of a statistically highly significant increase at the 5 %
level using standard χ2-technique for a 2 × 5 table in stump carcinomas following Billroth I resections supports
the thesis that there is no difference in the etiopathology of carcinogenesis in the
Billroth I as compared with the Billroth II remnant.
Key words:
Gastric stump carcinoma - Pathogenesis - Therapy - Prognosis
