Gastric stump cancer after stomach resection due to peptic disease

Stump cancer is the most severe late complication of stomach resection due to peptic disease. Recent clinical studies show an increase in the incidence of gastric carcinoma in patients who underwent stomach resection, in comparison to the general population. Cancers detected within the first four years following resection are considered a consequence of false pathological diagnosis. The etiologic factors which contribute to the development of "late" gastric carcinomas (20-40 years after initial operation) remain unknown. In this retrospective study, we have analysed the incidence of stomach cancer in the whole population of patients operated for peptic disease (stomach resection methods and vagotomy) in our Department over the "1973 to 1993" period. A total of 1343 patients were operated on for malignant diseases of the stomach, and 4531 patients underwent surgery for peptic disease. Gastric stump cancer surgery was performed in 35 (0.8%) patients following resection of the stomach for peptic disease. Their mean age was 63.5 years. An average of 21.4 years elapsed from the initial surgery to the diagnosis and reoperation of the stump cancer. Results of the study point to the importance of a systematic follow-up of patients who underwent stomach surgery due to peptic disease regardless of the surgery applied. Early detection of stomach cancer in previously operated patients is the most important factor contributing to their successful treatment.