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Gastric stump mucosa: is there a risk for carcinoma?
A V Safatle-Ribeiro1, U Ribeiro Júnior, P Sakai
1Gastrointestinal Endoscopic Unit, Department of Gastroenterology, University of São Paulo Medical School, SP, Brazil. adsafrib@dialdata.com.br
Background:
Patients who underwent partial gastric resections are at an increased risk for the development of cancer in the gastric remnant.
Aim:
To assess the long-term patients who underwent surgical treatment for peptic ulcer disease through endoscopic and pathologic evaluation of the gastric stump mucosal alterations.
Patients And Methods:
Between 1987 and 1990, 154 patients (mean = 20.4 years after gastrectomy) were evaluated by upper digestive endoscopy with multiple biopsies and pathological examination.
Results:
Endoscopic alterations were present in 111 patients (72.1%). The commonest pathologic alterations were foveolar hyperplasia, intestinal metaplasia and cystic dilation. Severe dysplasia was noted in two (1.25%) and carcinoma in 13 (8.4%) of the cases. In four patients (3.8%) the endoscopic findings did not show any evidence of tumors, however they were detected due to multiple biopsies and histologic studies.
Conclusions:
Surveillance of these patients with endoscopy and multiple biopsies may provide the means to diagnose tumors at an early stage, but the cost benefit ratio of surveillance requires further study.