Gastric stump mucosa: is there a risk for carcinoma?
BACKGROUND
Patients who underwent partial gastric resections are at an increased risk for the development of cancer in the gastric remnant.


OBJECTIVE
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.


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.
Safatle-Ribeiro
A V
AV
Gastrointestinal Endoscopic Unit, Department of Gastroenterology, University of São Paulo Medical School, SP, Brazil. adsafrib@dialdata.com.br
Ribeiro Júnior
U
U
Sakai
P
P
Iriya
K
K
Ishioka
S
S
Gama-Rodrigues
J
J
D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D005753:Gastric Mucosa; D018530:Gastric Stump; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000601:surgery*; D011184:Postoperative Period; D011230:Precancerous Conditions / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology