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Endoscopic diagnosis of gastric cancer in the remnant stomach



Endoscopic diagnosis of gastric cancer in the remnant stomach



Stomach & Intestine (Tokyo) 17(2): 1353-1358



Nineteen gastric cancers were found in the remnant stomach of 17 patients after gastrectomy for gastric cancer. Grossly, these cancers were chiefly polypoid and histologically differentiated adenocarcinoma. A correct diagnosis was made before operation in all the patients except in 2 cases: in these 2 cases the gastrofiberscope could not be inserted because of esophageal stenosis. Moreover, in 3 cases a correct diagnosis was not provided at the 1st endoscopic examination. In the 2 cases, the endoscopic diagnosis was either a benign gastric ulcer or a lesion near the cardiac orifice that was entirely missed. In the remaining 1 case, biopsy results were normal in contrast to visual diagnosis. A small caliber, forward-viewing fiberscope with a short bending section was highly effective inside the limited space of the cavity of the resected stomach. Retroflexion by a side-viewing fiberscope in the resected stomach was often difficult. For early detection of gastric cancers in resected stomachs, patients must be followed-up by a periodic endoscopic examination after gastrectomy. The Congo red-methylene blue test developed in this clinic was also useful for the early diagnosis of gastric cancer in the resected stomach. In this test, gastric cancers could be observed as white areas where the Congo red and methylene blue were bleached.

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Accession: 005359180

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