The three major causes of gastric stump cancer

5 to 10 years after surgery for benign peptic ulcer, adenocarcinoma may develop in the remaining stomach, which is called remnant stomach cancer. 1% to 5% of gastric cancer patients may develop remnant stomach cancer after surgery.

It is currently believed that the main cause of gastric stump cancer is the consequences of gastric surgery, which generally manifests in the following three aspects:

Gastric mucosal cancer

After gastric surgery, gastric acid is reduced, which is conducive to the growth and reproduction of bacteria in the stomach. Bacterial toxins and bile metabolites decomposed by bacteria can promote cancer. Bacteria containing nitrate reductase can promote the synthesis of carcinogens such as nitrosamines. Under the action of these carcinogens and cancer promoters, gastric mucosa may become cancerous.

Changes in physiological functions

Scars after gastric surgery and even stimulation from non-absorbable sutures may also be a factor in the occurrence of gastric stump cancer. Gastric surgery changes the normal anatomy and physiological function of the stomach, exposing the stomach to more carcinogens and cancer promoters. When the body's immune function is low, gastric stump cancer can occur.

Induce gastritis

After subtotal gastrectomy or vagus nerve transection, the stomach is in a low-acid or acid-free state, and the decreased secretion of gastrin reduces the protective mucus, causing the gastric mucosa to gradually atrophy. The reflux of bile, pancreatic juice and intestinal juice after gastric surgery further damages the gastric mucosa, forming chronic atrophic gastritis, intestinal metaplasia and atypical hyperplasia, which are important causes of residual gastric cancer.