Comparing reconstruction with ileocecal graft to jejunal interposition pouch after total gastrectomy in rats.

After total gastrectomy, the ileocecal graft may act as a reservoir and protect against reflux but give rise to transposition of the ileum and cause possible changes in bile acid metabolism and nutrition. This study compared the ileocecal graft and jejunal pouch. Male Wistar rats weighing 265 +/- 22 g were submitted to sham operation (S), ileocecal interposition graft (IIG), and jejunal pouch interposition graft (JP) after total gastrectomy. Eight weeks later, the esophagus was examined for evidence of esophagitis. Nutritional biochemistry and weight profile were documented preoperatively and 8 weeks after surgery. The oral glucose tolerance test was performed. Thirty-three rats were operated on and 30 survived for 8 weeks. Esophagitis occurred in seven JP rats. Body weight was significantly higher in IIG than in JP rats (p < .05). Normal glucose tolerance to intragastric glucose load was observed in sham and operated rats. JP rats had a significant decrease in serum albumin, glucose, transferrin, hemoglobin, iron, folate, and calcium, compared to sham (p < .05). Cobalamine was significantly lower in IIG rats than in JP rats (p < .05). In the IIG and JP groups, serum/hepatic total bile acid did not differ significantly from preoperative and sham values. In conclusion, the IIG interposition graft in rats prevented esophagitis, preserved nutrition, and did not interfere with enterohepatic total bile acid circulation.

Prevalence of Helicobacter pylori infection in advanced gastric carcinoma

BACKGROUD: There is substantial evidence that infection with Helicobacter pylori plays a role in the development of gastric cancer and that it is rarely found in gastric biopsy of atrophic gastritis and gastric cancer. On advanced gastric tumors, the bacteria can be lost from the stomach. AIMS: To analyze the hypothesis that the prevalence of H.pylori in operated advanced gastric carcinomas and adjacent non-tumor tissues is high, comparing intestinal and diffuse tumors according to Lauren's classification METHODS: A prospective controlled study enrolled 56 patients from "Hospital Universitário", Federal University of Rio Grande do Norte, Natal, RN, Brazil, with advanced gastric cancer, treated from February 2000 to March 2003. Immediately after partial gastrectomy, the resected stomach was opened and several mucosal biopsy samples were taken from the gastric tumor and from the adjacent mucosa within 4 cm distance from the tumor margin. Tissue sections were stained with hematoxylin and eosin. Lauren's classification for gastric cancer was used, to analyse the prevalence of H. pylori in intestinal or diffuse carcinomas assessed by the urease rapid test, IgG by ELISA and Giemsa staining. H. pylori infected patients were treated with omeprazole, clarithromycin and amoxicillin for 7 days. Follow-up endoscopy and serology were performed 6 months after treatment to determine successful eradication of H. pylori in non-tumor tissue. Thereafter, follow-up endoscopies were scheduled annually. Chi-square and MacNemar tests with 0.05 significance were used. RESULTS: Thirty-four tumors (60.7 percent) were intestinal-type and 22 (39.3 percent) diffuse type carcinomas. In adjacent non-tumor gastric mucosa, chronic gastritis were found in 53 cases (94.6 percent) and atrophic mucosa in 36 patients (64.3 percent). All the patients with atrophic mucosa were H. pylori positive. When examined by Giemsa and urease test, H. pylori positive rate in tumor...

RACIONAL: Existe evidência de que a infecção pelo Helicobacter pylori desempenha papel importante na causa do câncer gástrico e que é raramente encontrada em biopsias de gastrite atrófica e em tecido tumoral de câncer do estômago. Com a evolução para câncer gástrico avançado, a bactéria tende a desaparecer do tecido tumoral OBJETIVOS: Analisar a prevalência do H. pylori em peças operatórias de carcinomas gástricos avançados e no tecido adjacente aos tumores, comparando os tumores tipo intestinal e difuso de acordo com a classificação de Lauren MÉTODOS: Estudo prospectivo controlado incluiu 56 pacientes operados no Hospital Universitário da Universidade Federal do Rio Grande do Norte, Natal, RN, com câncer gástrico avançado, entre fevereiro de 2000 e março de 2003. Imediatamente após a gastrectomia, a peça operatória foi aberta e foram feitas várias biopsias do tecido neoplásico e da mucosa adjacente a 4 cm da margem tumoral. Os tecidos formam processados e corados pela hematoxilina-eosina. Foi usada a classificação de Lauren para carcinoma gástrico. A infecção pelo H. pylori foi diagnosticada pelo teste da urease, dosagem de IgG por ELISA e histopatologia com coloração Giemsa. Os pacientes infectados pelo H. pylori foram tratados com omeprazol, claritromicina e amoxicilina por 7 dias. Após 6 meses, 1 ano e 2 anos, foi feito seguimento utilizando endoscopia, dosagem de IgG e teste da urease para avaliar o sucesso da erradicação do H. pylori e recidiva do tumor RESULTADOS: O carcinoma tipo intestinal ocorreu em 34 (60,7 por cento) pacientes e 22 (39,3 por cento) foram acometidos de carcinoma difuso. No tecido adjacente não-tumoral a gastrite crônica foi observada em 53 casos (94,6 por cento) e mucosa atrófica em 36 pacientes (64,3 por cento), todos H. pylori positivos. Exames pelo Giemsa e teste da urease revelaram maior prevalência de H. pylori positivo no tecido tumoral do carcinoma tipo intestinal do que no tipo difuso. Quando foi comparada...

Prevalence of Helicobacter pylori infection in advanced gastric carcinoma.

BACKGROUND: [corrected] There is substantial evidence that infection with Helicobacter pylori plays a role in the development of gastric cancer and that it is rarely found in gastric biopsy of atrophic gastritis and gastric cancer. On advanced gastric tumors, the bacteria can be lost from the stomach. AIMS: To analyze the hypothesis that the prevalence of H.pylori in operated advanced gastric carcinomas and adjacent non-tumor tissues is high, comparing intestinal and diffuse tumors according to Lauren's classification METHODS: A prospective controlled study enrolled 56 patients from "Hospital Universitário", Federal University of Rio Grande do Norte, Natal, RN, Brazil, with advanced gastric cancer, treated from February 2000 to March 2003. Immediately after partial gastrectomy, the resected stomach was opened and several mucosal biopsy samples were taken from the gastric tumor and from the adjacent mucosa within 4 cm distance from the tumor margin. Tissue sections were stained with hematoxylin and eosin. Lauren's classification for gastric cancer was used, to analyse the prevalence of H. pylori in intestinal or diffuse carcinomas assessed by the urease rapid test, IgG by ELISA and Giemsa staining. H. pylori infected patients were treated with omeprazole, clarithromycin and amoxicillin for 7 days. Follow-up endoscopy and serology were performed 6 months after treatment to determine successful eradication of H. pylori in non-tumor tissue. Thereafter, follow-up endoscopies were scheduled annually. Chi-square and MacNemar tests with 0.05 significance were used. RESULTS: Thirty-four tumors (60.7%) were intestinal-type and 22 (39.3%) diffuse type carcinomas. In adjacent non-tumor gastric mucosa, chronic gastritis were found in 53 cases (94.6%) and atrophic mucosa in 36 patients (64.3%). All the patients with atrophic mucosa were H. pylori positive. When examined by Giemsa and urease test, H. pylori positive rate in tumor tissue of intestinal type carcinomas was higher than that in diffuse carcinomas. In tumor tissues, 34 (60.7%) H. pylori-positive in gastric carcinomas were detected by Giemsa method. H. pylori was observed in 30 of 56 cases (53.5%) in tissues 4 cm adjacent to tumors. This difference was not significant. Eradication of H. pylori in non-tumor tissue of gastric remnant led to a complete negativity on the 12th postoperative month CONCLUSIONS: The data confirmed the hypothesis of a high prevalence of H. pylori in tumor tissue of gastric advanced carcinomas and in adjacent non-tumor mucosa of operated stomachs. The presence of H. pylori was predominant in the intestinal-type carcinoma.