Gastric stump carcinoma -- carcinogenic factors and possible preventive measures

Cancer in the resected stomach has a very poor prognosis unless it is detected at the "early gastric cancer" stage. The development of gastric stump carcinoma is probably dependent on the procedure chosen for primary surgery (resection). Local irritation accompanying the execution of anastomosis is also discussed as a possible cause of malignant transformation. Surgical precautions should include the choice of methods avoiding reflux, and the use of resorbable suture material for performing an exact and well-matched anastomosis. Periodic postoperative control is essential; in addition to radiological methods, endoscopy and biopsy are indicated for adequate identification of local abnormalities and mucosal changes. Patients whose high risk was stated in previous examinations, must be re-examined at shorter intervals. Identification of changes at the early cancer stage requires close cooperation of surgeon and pathologist.