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KMID : 1188320170110020209
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Gut and Liver
2017 Volume.11 No. 2 p.209 ~ p.215
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Dynamic Changes in Helicobacter pylori Status Following Gastric Cancer Surgery
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Yoon Ki-Chul
Kim Na-Young
Kim Jae-Yeon
Lee Jung-Won
Lee Hye-Seung
Lee Jong-Chan
Yoon Hyuk
Shin Cheol-Min
Park Young-Soo
Ahn Sang-Hoon
Park Do-Joong
Kim Hyung-Ho
Lee Yoon-Jin
Lee Kyoung-Ho
Kim Young-Hoon
Lee Dong-Ho
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Abstract
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Background/Aims: Helicobacter pylori eradication is recommended in patients with early gastric cancer. However, the possibility of spontaneous regression raises a question for clinicians about the need for “retesting” postoperative H. pylori status.
Methods: Patients who underwent curative gastrectomy at Seoul National University Bundang Hospital and had a positive H. pylori status without eradication therapy at the time of gastric cancer diagnosis were prospectively enrolled in this study. H. pylori status and atrophic gastritis (AG) and intestinal metaplasia (IM) histologic status were assessed pre- and postoperatively.
Results: One hundred forty patients (mean age, 59.0 years; 60.7% male) underwent subtotal gastrectomy with B-I (65.0%), B-II (27.1%), Roux-en-Y (4.3%), jejunal interposition (0.7%), or proximal gastrectomy (4.3%). Preoperative presence of AG (62.9%) and IM (72.9%) was confirmed. The mean period between surgery and the last endoscopic follow-up was 38.0±25.6 months. Of the 140 patients, 80 (57.1%) were found to be persistently positive for H. pylori, and 60 (42.9%) showed spontaneous negative conversion at least once during follow-up. Of these 60 patients, eight (13.3%) showed more complex postoperative dynamic changes between negative and positive results. The spontaneous negative conversion group showed a trend of having more postoperative IM compared to the persistent H. pylori group.
Conclusions: A high percentage of spontaneous regression and complex dynamic changes in H. pylori status were observed after partial gastrectomy, especially in individuals with postoperative histological IM. It is better to consider postoperative eradication therapy after retesting for H. pylori.
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KEYWORD
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Helicobacter pylori, Postoperation, Eradication
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