[Bacterial colonization following resective and non-resective stomach-surgery (author's transl)]

Studies on why there is a higher disposition of carcinoma developing in the residual portion of the stomach of patients having undergone resections have led to the assumption that bacterial colonization constitutes a co-carcinogenic factor. It has been the purpose of this investigation to compare the ensuing bacterial growth following resective and nonresective stomach surgery. 120 Sprague-Dawley rats were divided into six groups: 1) control group: laparotomy. (2)SPV: with assured preservation of the antrum innervation. 3) SPV + Pypl.: the pyloroplasty was performed according to the Heinecke-upsilon. Mikulicz method. 4) TV + Pypl.: abdominal severance of the trunci nervi vagi. 5) BII: antecolonic without enteroanastomosis. 6) TV + BII. Eight months postoperative a smear was obtained under general anaesthesia from the transition segment between the fundus and antrum or at the site of the anastomosis. Tests for aerobic and anaerobic bacteria as well as cultures for fungi were begun. The control and SPV + Pypl. groups did not differ significantly in total bacteria count and in the ratio of nitrobacter. In contrast, the SPV group without pyloroplasty displayed an approximately tenfold higher concentration of nitrobacters--an amount equivalent to the sum of nitrobacters in the two resection techniques. The TV + BII group had a threefold higher total bacteria count than the BII group. According to our studies, a reduced stomach acid production, the bile secretion reflux and more importantly, a retarded food passage promote intragastric bacterial growth thus expediting the formation of intragastric carcinogenic nitrosamines.