Endoscopic review ofpatients whohavehadgastric surgery

Seventy onepatients who hadhadoperations on their stomachsover15yearspreviously were examinedby endoscopy andmultiple mucosalbiopsy sampling. Sixty sixhadhistologically provedgastritis (56chronic atrophic gastritis, 10superficial gastritis), 38intestinal metaplasia, and11epithelial dysplasia. Inthreecasestheepithelial dysplasia was severe(carcinoma insitu). One patient hadaninfiltrating carcinomaandanother, whosebiopsy appearances werereported asseveredysplasia, developed acarcinomaofthestomacheight monthslater. Allpatients havingundergone gastric surgerymore thanfiveyearspreviously shouldbe screenedendoscopically and anyfoundtohavemoderatedysplasia subjected to regular endoscopic screening thereafter. Patients withseveredysplasia (carcinoma insitu) should beconsidered forradical surgery.