The influence of partial gastrectomy for gastric cancer on the spontaneous disappearance of Helicobacter pylori: A single‐center prospective study

• Published in: Cancer reports Vol. 6; no. 12; pp. e1903 - n/a
• Main Authors: Yanagawa, Senichiro, Fujikuni, Nobuaki, Tanabe, Kazuaki, Nakahara, Masahiro, Noriyuki, Toshio
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-12-2023; John Wiley and Sons Inc; Wiley
• Subjects: Antigens; Body mass index; Chemotherapy; Clinical; Dissection; Endoscopy; Gastrectomy - adverse effects; Gastric cancer; Gastrointestinal surgery; Helicobacter Infections - complications; Helicobacter Infections - diagnosis; Helicobacter Infections - epidemiology; Helicobacter pylori; Hospitals; Humans; Infections; Lymphatic system; Lymphoma; Medical records; Metastasis; partial gastrectomy; Patients; Prospective Studies; Protons; spontaneous disappearance; Stomach Neoplasms - surgery; Japan; Helicobacter pylori; gastric cancer; partial gastrectomy; spontaneous disappearance
• ISSN: 2573-8348; 2573-8348
• DOI: 10.1002/cnr2.1903

Background/Aims
Helicobacter pylori (HP) eradication is recommended after endoscopic treatment of early gastric cancer (EGC). Cases of spontaneous HP resolution after partial gastrectomy due to environmental changes have been reported; however, there is no evidence for the efficacy of HP eradication in suppressing carcinogenesis and also no reports on the natural history of HP after partial gastrectomy in gastric cancer (GC). To report the natural history of HP in patients with GC and HP infection after partial gastrectomy.
Methods and Results
We prospectively studied the rate of spontaneous disappearance of HP after partial gastrectomy in patients with GC. From April 2016 to May 2020, 80 patients underwent partial gastrectomy, including 9 cases of proximal gastrectomy (PG), and 71 cases of distal gastrectomy (DG). The presence of HP was confirmed in the stool antigen test 1 year after operation, HP infection persisted in 46 patients (57.5%) and disappeared in 34 patients (42.5%). In univariate analysis, only proton pump inhibitor (PPI) use was a significant contributing factor for the spontaneous resolution of HP infection, especially in the DG group. However, there was no difference in the rates of HP disappearance between Billroth‐I and Roux‐en‐Y reconstructions in the DG group.
Conclusion
The HP spontaneously disappeared in 42.5% of the GC patients within 1 year after partial gastrectomy. Further investigation in a larger cohort is needed to elucidate the underlying mechanisms.