KINETIC CHANGES AND EXPERIMENTAL CARCINOGENESIS AFTER BILLROTH-I AND BILLROTH-II GASTRECTOMY
KINETIC CHANGES AND EXPERIMENTAL CARCINOGENESIS AFTER BILLROTH-I AND BILLROTH-II GASTRECTOMY
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DOI：
10.1002/bjs.1800800731
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发表时间：
1993-07-01
影响因子：
9.6
通讯作者：
HATTORI, T
中科院分区：
文献类型：
--
作者：
MIWA, K;KAMATA, T;HATTORI, T
为了根据手术重建的类型确定胃残癌的风险，雄性Wistar大鼠切除腺胃远端三分之二，然后进行胃十二指肠吻合（Billroth I型吻合）或胃空肠吻合（Billroth II型吻合）。没有使用致癌物，动物在手术后50周被杀死。22只大鼠行Billrothⅰ型胃切除术，无肿瘤发生，24只大鼠行Billrothⅱ型胃吻合术，有5只发生腺癌（P < 0.05）。所有肿瘤均局限于造口。采用Billroth II吻合术的动物吻合口处粘膜萎缩程度更高，囊性扩张、粘膜下腺囊性增生、假门化生发生率更高（P < 0.05）。Billroth II型胃切除术后，细胞动力学显示增殖区细胞数量增加，S期持续时间延长，细胞周期时间延长（P < 0.05）。这些结果表明，Billroth II型胃切除术比Billroth手术有更大的癌症风险。
To determine the risk of gastric remnant cancer according to the type of surgical reconstruction, the distal two-thirds of the glandular stomach was resected in male Wistar rats, followed by gastroduodenostomy (Billroth I anastomosis) or gastrojejunostomy (Billroth II anastomosis). No carcinogens were given and the animals were killed 50 weeks after operation. No cancers developed in 22 rats undergoing Billroth I gastrectomy, but five of 24 with Billroth II anastomosis had adenocarcinoma (P < 0.05). All carcinomas were confined to the stoma. Animals with Billroth II anastomosis had a more advanced grade of mucosal atrophy at the stoma, with a higher incidence of cystic dilatation, submucosal adenocystic proliferation and pseudopyloric metaplasia (P < 0.05). Cell kinetics in the stomal mucosa after Billroth II gastrectomy showed an increased cell count in the proliferative zone, longer duration of S phase and increased cell cycle time (P < 0.05). These results suggest that Billroth II gastrectomy carries a greater risk of cancer than the Billroth procedure.