Surgery for Remnant Gastric Cancer: Open Surgery

Abstract

Remnant gastric cancer is a type of complicated gastric cancer. Although no consensus definition has been established to date, the most popular definition of remnant gastric cancer is a cancer in the remaining stomach at least 5 years after gastrectomy, regardless of the reason for the primary surgery (i.e., whether it was for benign or malignant disease). In the 1970s and 1980s, gastrectomy was frequently performed for complicated peptic ulcer disease, and most instances of remnant gastric cancer were located in the stomach remaining after surgery for this benign disorder. Nowadays, gastrectomy for benign disease has become less frequent because of the development of effective medical treatment for peptic ulcer disease, which has led to a decrease in the frequency of remnant gastric cancer after surgery for benign disease. By contrast, nationwide mass screening for gastric cancer has increased the proportion of early gastric cancers detected in Korea and Japan, and treatment strategies for gastric cancer have improved, leading to longer survival of patients with gastric cancer. Unlike gastric cancers in Western countries, which generally occur in the upper third of the stomach, 60–70% of gastric cancers in Korea and Japan occur in the distal stomach and are usually treated by distal gastrectomy. Consequently, the incidence of remnant gastric cancer is expected to increase, especially in East Asia.