Progress in clinical diagnosis and treatment strategies for gastric stump cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANGChaoyang ¹ , CAIZhonglin ¹ , SHIXin ² , JIXiang ² ,  LIUHongbin ²

1. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, P.R.China;
2. Department of General Surgery, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, P.R.China;

Corresponding author：

LIUHongbin, Email: Liuhongbin999@163.com

Keywords：

gastric stump cancer; pathogenesis; lymph node dissection; therapeutic laparoscopy; prognosi

DOI：

10.7507/1007-9424.201605103

Video：

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Objective To summarize the progress on diagnosis and treatment of gastric stump cancer. Methods Related literatures in recent 5 years were collected, and the progress on diagnosis and treatment of gastric stump cancer were reviewed. Results The diagnosis of gastric stump cancer mainly depends on endoscopy, mucosal biopsy and other imaging examinations. At present, the main treatment of gastric stump cancer is the total gastrectomy, combined with laparoscopic therapy and endoscopic therapy. On the basis of No.1-No.4 and No.7-No.13 lymph node dissection, the extent of lymph node dissection is enlarged according to the different surgical procedures. Conclusions The main treatment of gastric stump cancer is total gastrectomy, and there are many factors affecting the prognosis, which should be early diagnosis and early treatment. Laparoscopic radical gastrectomy for gastric stump caner provides a more convenient and accurate method for the treatment of gastric stump caner.

Citation： WANGChaoyang, CAIZhonglin, SHIXin, JIXiang, LIUHongbin. Progress in clinical diagnosis and treatment strategies for gastric stump cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(1): 120-123. doi: 10.7507/1007-9424.201605103 Copy

1.	陈万青, 张思维, 郑荣寿, 等. 中国2009年恶性肿瘤发病和死亡分析. 中国肿瘤, 2013, 22(1): 7-8.
2.	田磊, 肖秀英, 叶明. 残胃癌的临床病理特征及预后分析. 肿瘤, 2015, 35(3): 301-311.
3.	Balfour DC. Factors influencing the life expectancy of patients operated on for gastric ulcer. Ann Surg, 1922, 76(3): 405-408.
4.	胡祥. 第14版日本《胃癌处理规约》的重要变更. 中国实用外科志, 2010, 30(4): 241-246.
5.	程金玉. 胃手术后残胃癌的实验研究. 中国医药指南, 2012, 10(4): 171-172.
6.	Lagergren J, Lindam A, Mason RM. Gastric stump cancer after distal gastrectomy for benign gastric ulcer in apopulation-based study. Int J Cancer, 2012, 131(6): E1048-E1052.
7.	Ojima T, Iwahashi M, Nakamori M,et al. Clinicopathological characteristics of remnant gastric cancer after a distal gastrectomy. J Gastrointest Surg, 2010, 14(2): 277-281.
8.	钟晓刚, 殷舞, 麦威, 等. 残胃癌外科治疗临床分析及再认识. 中国普外基础与临床杂志, 2012, 19(1): 20-24.
9.	钟晓刚, 殷舞, 黄顺荣. 幽门螺杆菌与残胃癌发生的研究进展. 世界华人消化杂志, 2010, 18(30): 3200-3203.
10.	Osugi H, Fukuhara K, Takada N,et al. Reconstructive procedure after distal gastrectomy to prevent remnant gastritis. Hepatogastroenterology, 2004, 51(58): 1215-1218.
11.	洪黎清, 陈志山, 杨昌毅, 等. 残胃癌的病因及预防对策分析. 中国肿瘤外科杂志, 2013, 5(4): 209-214.
12.	Nakagawara H, Miwa K, Nakamura S,et al. Duodenogastric refluxsustains Helicobacter pylori infection in the gastric stump. Scand J Gastroenterol, 2003, 38(9): 931-937.
13.	Morgagni P, Gardini A, Marrelli D,et al. Gastric stump carcinoma after distal subtotal gastrectomy for early gastric cancer: experience of 541 patients with long-term follow-up. Am J Surg, 2015, 209(6): 1063-1068.
14.	Komatsu S, Ichikawa D, Okamoto K,et al. Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy. World J Gastroenterol, 2012, 18(22): 2832-2836.
15.	Tokunaga M, Sano T, Ohyama S,et al. Clinicopathological characteristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer. J Gastrointest Surg, 2013, 17(2): 313-318.
16.	Hirao M, Takiguchi S, Imamura H,et al. Comparison of Billroth Ⅰ and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer: one-year postoperative effects assessed by a multi-institutional RCT. Ann Surg Oncol, 2013, 20(5): 1591-1597.
17.	Xiong JJ, Altaf K, Javed MA,et al. Roux-en-Y versus Billroth Ⅰreconstruction after distal gastrectomy for gastric cancer: a meta-analysis. World J Gastroenterol, 2013, 19(7): 1124-1134.
18.	曹春远. 老年残胃癌早期诊断及治疗. 中国老年学杂志, 2011, 31(3): 511-512.
19.	施伟斌, 梅佳玮, 王雪峰, 等. 残胃癌的临床特征及外科治疗. 浙江临床医学, 2011, 13(4): 374-376.
20.	吴齐, 李子禹, 步昭德. 残胃癌术前超声内镜分期诊断作用研究. 中国实用外科杂志, 2009, 29(10): 836-838.
21.	Safatle-Ribeiro AV, Ribeiro U Jr, Reynolds JC. Gastric stump cancer what is the risk. Dig Dis, 1998, 16(3): 159-168.
22.	Lee IJ, Lee JM, Kim SH,et al. Helical CT evaluation of the preoperative staging of gastric cancer in the remnant stomach. Am J Roentgenol, 2009, 192(4): 902-908.
23.	孙永康. 残胃癌的X线早期诊断. 医学影像学杂志, 2010, 20(4): 508-510.
24.	Takenaka R, Kawahara Y, Okada H,et al. Endoscopic submucosal dissection for cancers of the remnant stomach after distalgastrectomy. Gastrointest Endosc, 2008, 67(2): 359-363.
25.	Hirasaki S, Kanzaki H, Matsubara M,et al. Treatment of gastricremnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife. World J Gastroenterol, 2008, 14(16): 2550-2555.
26.	Corcione F, Pirozzi F, Marzano E,et al. Laparoscopic approachto gastric remnat-stump: our initial successfu1 experience on 3 cases. Surg Laparosc Percutan Tech, 2008, 18(5): 502-505.
27.	王培红, 曹永宽, 张林, 等. 残胃癌的淋巴结转移规律及外科治疗. 西部医学, 2011, 23(1): 80-83.
28.	卫洪波, 陈规划, 郑宗衍, 等. 胃癌全胃切除术后三种消化道重建术式的比较观察(附106例临床分析). 中国实用外科杂志, 2003, 23(6): 360-361.
29.	Fein M, Fuchs KH, Thalheimer A,et al. Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a ran domized tria. Ann Surg, 2008, 247(5): 759-765.
30.	Kurita N, Shimada M, Chikakiyo M,et al. Does Roux-en Y reconstruction with jejuna pouch after total gastrectomy prevent complications of postgastrectomy. Hepatogastroenterology, 2008, 55(86-87): 1851-1854.
31.	Goh PM, Khan AZ, So JB,et al. Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech, 2001, 11(2): 83-87.
32.	刘宏斌, 李洪涛, 韩晓鹏, 等. 腹腔镜残胃癌根治术. 中华消化外科杂志, 2013, 12 (5): 340-343.
33.	Etoh T, Inomata M, Shiraishi N,et al. Minimally invasive approaches for gastric cancer-Japanese experiences. J Surg Oncol, 2013, 107(3): 282-288.
34.	臧潞, 郑民华, 薛佩, 等. 完全腹腔镜根治性全胃切除术后食管空肠三角吻合的近期疗效. 中华消化外科杂志, 2014, 13(2): 134-138.
35.	刘宏斌, 于建平, 许威, 等. 腹腔镜残胃癌根治术空肠R型代胃食管-空肠三角吻合技术的应用研究. 中国肿瘤临床, 2015, 42(5): 307-312.

1. 陈万青, 张思维, 郑荣寿, 等. 中国2009年恶性肿瘤发病和死亡分析. 中国肿瘤, 2013, 22(1): 7-8.
2. 田磊, 肖秀英, 叶明. 残胃癌的临床病理特征及预后分析. 肿瘤, 2015, 35(3): 301-311.
3. Balfour DC. Factors influencing the life expectancy of patients operated on for gastric ulcer. Ann Surg, 1922, 76(3): 405-408.
4. 胡祥. 第14版日本《胃癌处理规约》的重要变更. 中国实用外科志, 2010, 30(4): 241-246.
5. 程金玉. 胃手术后残胃癌的实验研究. 中国医药指南, 2012, 10(4): 171-172.
6. Lagergren J, Lindam A, Mason RM. Gastric stump cancer after distal gastrectomy for benign gastric ulcer in apopulation-based study. Int J Cancer, 2012, 131(6): E1048-E1052.
7. Ojima T, Iwahashi M, Nakamori M,et al. Clinicopathological characteristics of remnant gastric cancer after a distal gastrectomy. J Gastrointest Surg, 2010, 14(2): 277-281.
8. 钟晓刚, 殷舞, 麦威, 等. 残胃癌外科治疗临床分析及再认识. 中国普外基础与临床杂志, 2012, 19(1): 20-24.
9. 钟晓刚, 殷舞, 黄顺荣. 幽门螺杆菌与残胃癌发生的研究进展. 世界华人消化杂志, 2010, 18(30): 3200-3203.
10. Osugi H, Fukuhara K, Takada N,et al. Reconstructive procedure after distal gastrectomy to prevent remnant gastritis. Hepatogastroenterology, 2004, 51(58): 1215-1218.
11. 洪黎清, 陈志山, 杨昌毅, 等. 残胃癌的病因及预防对策分析. 中国肿瘤外科杂志, 2013, 5(4): 209-214.
12. Nakagawara H, Miwa K, Nakamura S,et al. Duodenogastric refluxsustains Helicobacter pylori infection in the gastric stump. Scand J Gastroenterol, 2003, 38(9): 931-937.
13. Morgagni P, Gardini A, Marrelli D,et al. Gastric stump carcinoma after distal subtotal gastrectomy for early gastric cancer: experience of 541 patients with long-term follow-up. Am J Surg, 2015, 209(6): 1063-1068.
14. Komatsu S, Ichikawa D, Okamoto K,et al. Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy. World J Gastroenterol, 2012, 18(22): 2832-2836.
15. Tokunaga M, Sano T, Ohyama S,et al. Clinicopathological characteristics and survival difference between gastric stump carcinoma and primary upper third gastric cancer. J Gastrointest Surg, 2013, 17(2): 313-318.
16. Hirao M, Takiguchi S, Imamura H,et al. Comparison of Billroth Ⅰ and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer: one-year postoperative effects assessed by a multi-institutional RCT. Ann Surg Oncol, 2013, 20(5): 1591-1597.
17. Xiong JJ, Altaf K, Javed MA,et al. Roux-en-Y versus Billroth Ⅰreconstruction after distal gastrectomy for gastric cancer: a meta-analysis. World J Gastroenterol, 2013, 19(7): 1124-1134.
18. 曹春远. 老年残胃癌早期诊断及治疗. 中国老年学杂志, 2011, 31(3): 511-512.
19. 施伟斌, 梅佳玮, 王雪峰, 等. 残胃癌的临床特征及外科治疗. 浙江临床医学, 2011, 13(4): 374-376.
20. 吴齐, 李子禹, 步昭德. 残胃癌术前超声内镜分期诊断作用研究. 中国实用外科杂志, 2009, 29(10): 836-838.
21. Safatle-Ribeiro AV, Ribeiro U Jr, Reynolds JC. Gastric stump cancer what is the risk. Dig Dis, 1998, 16(3): 159-168.
22. Lee IJ, Lee JM, Kim SH,et al. Helical CT evaluation of the preoperative staging of gastric cancer in the remnant stomach. Am J Roentgenol, 2009, 192(4): 902-908.
23. 孙永康. 残胃癌的X线早期诊断. 医学影像学杂志, 2010, 20(4): 508-510.
24. Takenaka R, Kawahara Y, Okada H,et al. Endoscopic submucosal dissection for cancers of the remnant stomach after distalgastrectomy. Gastrointest Endosc, 2008, 67(2): 359-363.
25. Hirasaki S, Kanzaki H, Matsubara M,et al. Treatment of gastricremnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife. World J Gastroenterol, 2008, 14(16): 2550-2555.
26. Corcione F, Pirozzi F, Marzano E,et al. Laparoscopic approachto gastric remnat-stump: our initial successfu1 experience on 3 cases. Surg Laparosc Percutan Tech, 2008, 18(5): 502-505.
27. 王培红, 曹永宽, 张林, 等. 残胃癌的淋巴结转移规律及外科治疗. 西部医学, 2011, 23(1): 80-83.
28. 卫洪波, 陈规划, 郑宗衍, 等. 胃癌全胃切除术后三种消化道重建术式的比较观察(附106例临床分析). 中国实用外科杂志, 2003, 23(6): 360-361.
29. Fein M, Fuchs KH, Thalheimer A,et al. Long-term benefits of Roux-en-Y pouch reconstruction after total gastrectomy: a ran domized tria. Ann Surg, 2008, 247(5): 759-765.
30. Kurita N, Shimada M, Chikakiyo M,et al. Does Roux-en Y reconstruction with jejuna pouch after total gastrectomy prevent complications of postgastrectomy. Hepatogastroenterology, 2008, 55(86-87): 1851-1854.
31. Goh PM, Khan AZ, So JB,et al. Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech, 2001, 11(2): 83-87.
32. 刘宏斌, 李洪涛, 韩晓鹏, 等. 腹腔镜残胃癌根治术. 中华消化外科杂志, 2013, 12 (5): 340-343.
33. Etoh T, Inomata M, Shiraishi N,et al. Minimally invasive approaches for gastric cancer-Japanese experiences. J Surg Oncol, 2013, 107(3): 282-288.
34. 臧潞, 郑民华, 薛佩, 等. 完全腹腔镜根治性全胃切除术后食管空肠三角吻合的近期疗效. 中华消化外科杂志, 2014, 13(2): 134-138.
35. 刘宏斌, 于建平, 许威, 等. 腹腔镜残胃癌根治术空肠R型代胃食管-空肠三角吻合技术的应用研究. 中国肿瘤临床, 2015, 42(5): 307-312.

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Progress in clinical diagnosis and treatment strategies for gastric stump cancer

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