[Pathogenesis of cancer of the operated stomach]

Carcinoma in the postsurgical stomach has to be considered as a prognostically hopeless late complication in the wake of reflux-causing stomach operations. Morphological, autoradiographic, microbiological, and biochemical investigations of animal models and analyses of 19,595 postmortem records have supported the view that enterogastric reflux, bacterial colonisation, primarily by nitrate-reducing enterobacteria, alteration of the intragastric pH condition as well as consecutive morphological and functional changes to gastric mucosa are factors of pathogenetic relevance. Reflux-preventing surgical methods should be adopted to handle the problem, among them application of Roux-en-Y anastomosis or jejunal interposition following gastrectomy. Systematic postsurgical follow-up care is considered to be just as important.