A CASE OF REMNANT GASTRIC CANCER 10 YEARS AFTER DISTAL GASTRECTOMY FOR ADVANCED GASTRIC CANCER, AND REVIEW OF THE SIMILAR SIX CASES IN OUR HOSPITAL

Abstract

A case of early remnant gastric cancer 10 years after distal gastrectomy for advanced gastric cancer is reported. A 71-year-old man complained of discomfort of the epigastric region and diagnosed early remnant gastric cancer. The total gastrectomy was performed. There were 6 cases of remnant gastric cnacer after distal gastrectomy in our hospital. We have experienced a total of six cases of remnant gastric cancer after distal gastrectomy, that occurred with an incidence of 1.5% in our all operative gastric cnacer. The mean age was 66.1 years and all patients were male. The diseases caused the first operation were gastric ulcer in four, duodenal ulcer and gastric cancer in each one case. The reconstruction of the first operation were Billroth 2 for four patients and Billroth 1 for two. The mean duration between the first operation and the diagnosis of remnant gastric cancer was 14 years. The chief complaints included dysphagia in two patients, epigastralgia and palpable tumor in one, hematmesis and tarry stool in one, and discomfort of the epigastric region in one. Only one patient who diagnosed at the adult mass screening for gastric cancer was no complaint. Operative procedure for remnant stomach were subtotal gastrectomy for three patients and total gastrectomy for three patients. Transverse colon resection was performed for two patients and pancreas tail resection and splenectomy for two. There were three patients in stage III, one in stage IV, and two in stage I in conformity with The General Rules for the Gastric Cancer Study in Japan. There were one Borrmann 1 type, one Borrmann 2 type, three Borrmann 3 type, and one IIa type early gastric cancer. Three cases are now surviving for 10 months, 1 year and 1 month, and 5 years respectively with no evidence of recurrence.