Evaluation of Patients with Gastrectomy for Malignity of Anastomosis Line

Aim: We aimed at evaluating the Histopathological examination results of biopsies obtained from the anastomosis line of patients with previous gastrectomy in terms of malignancy. Material and Method: The endoscopic findings and the biopsy records obtained from the anastomosis line of 23 patients with gastrectomy history for whom upper gastrointestinal system (GIS) endoscopy was performed at the General Surgery Clinic, Endoscopy Unit of Training & Research Hospital in Konya between Jan. 2009 and Dec. 2011 were retrospectively examined for the existence of Helicobacter pylori, intestinal metaplasia (IM), dysplasia and cancer. Results: The average age of patients was 63 (range 30-82), with 17 males (74%) and 6 females (26%). 15 (65%) of these patients had undergone a gastrectomy for a malignity, and 8 (35%) for a benign reason. The time elapsed after the surgical operation was 46 (range 12-144) months in average. 17 (74%) of these surgical operations were Billroth II, 3 (13%) gastroenterostomy without resection, 2 (9%) total gastrectomy, and 1 (4%) Billroth I. Upper GIS endoscopy revealed alkaline reflux gastritis at 14 (61%) patients, anastomosis ulcer at 6 (26%) patients, polyp at 2 (9%) patients, and cancer at 1 (4%) patient. Histopathological examination of the biopsy results displayed 5 (22%) reactive hyperplasic changes, 5 (22%) chronic active gastritis, 5 (22%) dysplasia, 3 (13%) IM, and 2 (9%) cancer. Discussion: Patients with gastrectomy history develop IM in the anastomosis line in parallel with the time elapsed after surgical operation, and subsequently develop dysplasia. Monitoring with endoscopy will make diagnosis and appropriate treatment possible in the stage of dysplasia