Clinicopathological Study on Mucosal Changes of the Remnant Stomach Following Distal Gastrectomy for Gastric Cancer

Tetsuzo Shiozaki

The First Department of Surgery, Juntendo University School of Medicine (Director: Prof. Noburu Sakakibara)

In the postoperative follow-up of gastric cancer patients, it is very important to examine the mucosal changes in the remnant stomach. For a pathological study of the mucosal changes following gastrectomy, 58 patients who had undergone distal gastrectomy for gastric cancer were divided into three groups according to the mucosal condition of the resected stomach at the time of surgery, as follows. Group A: the F-line was completely visible in the resected stomach, group B: the line of resection was located across the F-line, group C: the F-line was not detected in the resected stomach. Based on endoscopic biopsy tissue findings of the anastomotic regions and the corporeal regions of the remnant stomach, postoperative mucosal changes with time were studied in the three groups. The following results were obtained: 1) Hyperplastic changes in the foveolar epithelium (of the anastomotic regions) increased with time in group A. Such changes were marked in group C within 2 years of surgery, then gradually diminished, especially after 5 years. 2) The intestinal metaplasia tended to increase with time in both the anastomotic regions and the corporeal regions in all three groups. Patients who had no such metaplastic changes at the time of the operation were found to have developed intestinal metaplasia in the remnant stomach within 2 years of surgery, which spread progressively in periods of 2∼5 years and more than 5 years. 3) Inflammatory cell infiltration was more marked in the anastomotic regions than in the corporeal regions, but these findings did not change with time.

Key words
remnant stomach, distal gastrectomy for gastric cancer, foveolar epithelium hyperplasia, intestinal metaplasia, inflammatory cell infiltration

Reprint requests
Tetsuzo Shiozaki The First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
February 13, 1991

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