[Peptic ulcer: changing indications for gastric resection during the last 15 years]. / Ulcera peptica: cambiamento di indicazione alla resezione gastrica negli ultimi 15 anni.

In this study the authors want to underline the changing strategies for peptic ulcer disease. Considering the experience of two Surgery Departments in Piedmont, the G. Bosco Hospital of Turin and the S. Croce Hospital of Moncalieri, in the last 15 years, they observed a notable reduction of gastric resections owing to new drugs such as H2-antagonist and omeprazole in peptic ulcer therapy. The authors report, therefore, recent suggestions to gastric resection in the cases of complicated ulcer or not. Today pyloric stenosis due to chronic ulcer no longer operated and perforated ulcer is resected only when there is a great gastric hole, or a relapse perforation or a bleeding together to perforation. On the contrary hemorrhagic ulcer is operated when the bleeding is either notable, or relapse, or continuous, or untransfusible.

[Diagnosis, treatment and prognosis of gastric stump cancer]. / Diagnosi, trattamento e prognosi del cancro del moncone gastrico.

The authors report 10 cases of gastric stump cancer undergoing operation in the Surgical Department of S. Croce Hospital in Moncalieri between 1978 and 1993, 9 men and 1 woman aged approximate by 67 years. The first operation was a Billroth II with reconstruction according to Polya or Kroenlein. The disease-free period was on average thirty years. In 5 cases the operation was palliative (GEA+Braun) for cancer at fourth stage, in 3 cases radical for cancer in early stage, in 2 cases total gastrectomy+Y for one cancer in early stage and one cancer at II stage TNM. The actuarial survival after 5 years is 50% and this result is satisfactory thanks to four cases of early stump cancer. From our experience, though of only 10 patients, we can deduce that total gastrectomy or degastroresection, in early stage have the same index of survival.