Gut and Liver 2007; 1(1): 022-026 https://doi.org/10.5009/gnl.2007.1.1.22 Endoscopic Screening for Remnant Gastric Cancer: Points to be Considered
Author Information
Jung Ho Park*, Jun Haeng Lee*, Poong-Lyul Rhee*, Jae J. Kim*, Jong Chul Rhee*, Sung Kim†, and Cheol Keun Park‡
Departments of *Medicine, †Surgery and ‡Pathology, Sungkyunkwan University School of Medicine, Seoul, Korea

Jun Haeng Lee
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: It is difficult to detect early gastric cancer (EGC) during endoscopic surveillance because the remnant stomach is usually deformed after surgical resection and the mucosa at the gastric stump are changed due to bile reflux. In this study, we aimed to determine the characteristic endoscopic findings of cancer in the remnant stomach. Methods: Fifty-five remnant gastric cancer (RGC) patients were classified into three groups according to location and elapsed time after surgery. Among 32 RGCs that developed less than 10 years after surgery, 21 lesions were located close to the anastomosis site (recurrent cancers), whereas 11 lesions were not (residual cancers). Twenty-three cancers developed at least 10 years after surgery (newly developed cancers). The endoscopic features were compared among these groups. Results: Most patients (29/32, 91%) with residual or recurrent cancer developed their tumors within five years after surgery, and the proportion of EGC was 43.8% (14/32). However, 91.3% (21/23) of newly developed cancers were advanced gastric cancers. When classified according to the Japanese classification system for EGC, 71% (5/7) of the residual cancers were of the elevated type, whereas 86% (6/7) of the recurrent cancers were of the depressed type (p=0.00). Conclusions: During the first 5 years after subtotal gastrectomy, endoscopists should mainly try to find depressed lesions on the anastomosis site as well as elevated lesions on the non-anastomosis site. (Gut and Liver 2007;1:22-26)
Keywords: Gastric cancer; Stump; Gastrectomy
Abstract
Background/Aims: It is difficult to detect early gastric cancer (EGC) during endoscopic surveillance because the remnant stomach is usually deformed after surgical resection and the mucosa at the gastric stump are changed due to bile reflux. In this study, we aimed to determine the characteristic endoscopic findings of cancer in the remnant stomach. Methods: Fifty-five remnant gastric cancer (RGC) patients were classified into three groups according to location and elapsed time after surgery. Among 32 RGCs that developed less than 10 years after surgery, 21 lesions were located close to the anastomosis site (recurrent cancers), whereas 11 lesions were not (residual cancers). Twenty-three cancers developed at least 10 years after surgery (newly developed cancers). The endoscopic features were compared among these groups. Results: Most patients (29/32, 91%) with residual or recurrent cancer developed their tumors within five years after surgery, and the proportion of EGC was 43.8% (14/32). However, 91.3% (21/23) of newly developed cancers were advanced gastric cancers. When classified according to the Japanese classification system for EGC, 71% (5/7) of the residual cancers were of the elevated type, whereas 86% (6/7) of the recurrent cancers were of the depressed type (p=0.00). Conclusions: During the first 5 years after subtotal gastrectomy, endoscopists should mainly try to find depressed lesions on the anastomosis site as well as elevated lesions on the non-anastomosis site. (Gut and Liver 2007;1:22-26)
Keywords: Gastric cancer; Stump; Gastrectomy
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