[The stomach after surgery--on the incidence of pathologic changes from the endoscopic viewpoint]

The incidence of pathological changes in the wake of stomach surgery amounted to 483 of 550 patients who were endoscopically examined at the Outpatient Department of Surgery attached to the Medical Academy of Erfurt, between January 1st, 1975 and December 31st, 1985. These were 87.8 per cent. Similar findings were recorded from 67 vagotomised patients (12.2 per cent). These 550 cases represented 6.7 per cent of 8,155 patients whose upper digestive tract had been endoscopically examined throughout the above period of time. The first endoscopic check was applied to 49.9 per cent only five or more years, following surgery and to 44.8 per cent within two years from surgery. Pain was recorded as the major symptom and indication for the follow-up checks from 75 per cent of these patients. Pathological changes were endoscopico-macroscopically detectable from 75 per cent of the probands. Ulcers were observed in 20 per cent. Inflammatory changes accounted for 40 per cent in both groups. Tumours were established in ten per cent. Macroscopic findings were histologically verified in 208 cases (37.8 per cent), among them 41.2 per cent after stomach resection and 13.2 per cent following vagotomy. Suspicious diagnoses of inflammation was thus positively verified in 93.4 per cent of all cases and those of malignant tumours in 39 of 47 cases. Inflammatory processes were histologically detected in 31 cases in which it had been neither assumed nor formulated. In eight histologically established tumour cases that diagnosis had not been macroscopically made (inflammations in seven cases and no contributory findings in one). Macroscopic findings recorded from the above selected group of patients proved to be reliable for tumours in 85 per cent of all cases and for gastritis in 93 per cent. Endoscopic follow-up diagnosis should begin within the first year from stomach surgery and should be persistently continued on the basis of a systematic extended medical care programme. All the above findings were gained on the basis of high-continuity computer-adjusted data collection and evaluation.