Gastric remnant carcinoma: descriptive study of the last 12 years' experience

Background. The incidence of gastric remnant carcinoma ranges between 1% an d 9%, We report here our experience in a sanitary area in which, on account of different social and working reasons, the surgical indication for treat ment of peptic disease was very common in previous decades. Patients and methods, An analysis was made of the 52 cases of patients oper ated over the last 12 years, which represents 7.13% of 729 gastric cancers operated over the same time period. Results. In 67% of cases the carcinoma sat on a type-II stump, in 25% on a B-I type stump, and in the remaining 8% on stomachs with vagotomy and pylor oplasty, Seventy-five percent of patients had two characteristics: to be ol der than 60 years and to have undergone primary surgery at least 15 years b efore. Over half of patients were admitted on an emergency basis with no di agnosis and had received prolonged symptomatic therapies without previous e xaminations. The carcinoma involved the anastomotic mouth in 56% of cases a nd the histologic intestinal type predominated. Twenty-seven percent of pat ients had stages I and II, whereas almost half of patients had stage IV. Su rgical resection was feasible in 42 cases (81%), with a surgical mortality rate of 21% for resections. The overall survival rate estimated at 5 years was 23%. Conclusions, The possibility of performing surgery with a curative aim is t he main prognostic factor for the gastric remnant carcinoma. The endoscopic study of patients at risk allows for diagnosis in earlier stages and there fore and improvement in results.