Japanese

Prolonged Endoscopic Surveillance of Gastric Remnant Cancer after Early Cancer Surgery Osamu Hosokawa 1 , Yasuharu Kaizaki 2 , Makoto Morishita 1 , Masakazu Hatorri 1 , Kenji Douden 1 1The Department of Surgery, Fukui Prefectural Hospital 2The Department of Pathology, Fukui Prefectural Hospital Keyword: 残胃癌 , 早期胃癌術後 , 内視鏡サーベイランス , 累積罹患率 , H. pylori感染 pp.985-995
Published Date 2004/6/25
DOI https://doi.org/10.11477/mf.1403100519
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 The aim of this article was to clarify the incidence of gastric remnant cancer after operation for early gastric cancer and to develop surveillance programs for patients partially gastrectomized in order to detect these remnant cancers at the early stage.

 A total of31out of1,487patients gastrectomized for early gastric cancer between1985and2001were diagnosed as having gastric remnant cancer. All gastric remnant cancers except one lesion were found distant from the site of the anastomosis and, in half of the patients, the cancers were located on the lesser curvature. In22patients the cancers were detected in the early stage and in9patients in the advanced stage. The interval from the preceding examination to diagnosis was shorter in the patients with early cancer than those with advanced cancer(p<0.01).

 In797patients, the interval between endoscopic examinations was periodic. Among these patients,22patients were diagnosed as having gastric remnant cancer. The cumulative five-year prevalence rate was estimated as2.4%, the ten-year prevalence rate as5.6% and the fifteen-year prevalence rate as8.3%. Gastric remnant cancer was more often detected significantly in patients whose initial tumors were multiple or microscopically differentiated type. The prevalence of H. pylori infection was found to decrease in the gastric remnant after the initial surgery.

 Periodical surveillance endoscopy for gastric remnant cancer is recommended after operation for early gastric cancer, particularly in patients whose cancers are microscopically differentiated type. It may be advisable to repeat examinations at two to three year intervals and special attention should be focused on the lesser curvature distal from the anastomotic site.

 1) The Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan

 2) The Department of Pathology, Fukui Prefectural Hospital, Fukui, Japan


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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