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Basso L, Gallo G, Biacchi D, Carati MV, Cavallaro G, Esposito L, Giuliani A, Izzo L, Izzo P, Lamazza A, Polistena A, Tarallo M, Micarelli A, Fiori E. Role of New Anatomy, Biliopancreatic Reflux, and Helicobacter Pylori Status in Postgastrectomy Stump Cancer. J Clin Med 2022; 11:1498. [PMID: 35329824 PMCID: PMC8952228 DOI: 10.3390/jcm11061498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 01/14/2023] Open
Abstract
Distal gastrectomy for benign gastroduodenal peptic disease has become rare, but it still represents a widely adopted procedure for advanced and, in some countries, even for early distal gastric cancer. Survival rates following surgery for gastric malignancy are constantly improving, hence the residual mucosa of the gastric stump is exposed for a prolonged period to biliopancreatic reflux and, possibly, to Helicobacter pylori (HP) infection. Biliopancreatic reflux and HP infection are considered responsible for gastritis and metachronous carcinoma in the gastric stump after oncologic surgery. For gastrectomy patients, in addition to eradication treatment for cases that are already HP positive, endoscopic surveillance should also be recommended, for prompt surveillance and detection in the residual mucosa of any metaplastic-atrophic-dysplastic features following surgery.
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Affiliation(s)
- Luigi Basso
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Gaetano Gallo
- Department of Medicine, Surgery and Neurosciences, Operative Unit of General Surgery and Surgical Oncology, University of Siena, 53100 Siena, Italy
| | - Daniele Biacchi
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Maria Vittoria Carati
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Giuseppe Cavallaro
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Luca Esposito
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Andrea Giuliani
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Luciano Izzo
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Paolo Izzo
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Antonietta Lamazza
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Andrea Polistena
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Mariarita Tarallo
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
| | - Alessandro Micarelli
- ITER Center for Balance and Rehabilitation Research (ICBRR), 02032 Rome, Italy;
- Eurac Research, Institute of Mountain Emergency Medicine, 39100 Bolzano, Italy
| | - Enrico Fiori
- “Pietro Valdoni” Department of Surgery, Policlinico “Umberto I”, “Sapienza” University of Rome, 00161 Rome, Italy; (D.B.); (M.V.C.); (G.C.); (L.E.); (A.G.); (L.I.); (P.I.); (A.L.); (A.P.); (M.T.); (E.F.)
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