Prospective endoscopic follow-up results of reconstructed gastric tube.

Background/aims: Recent advances in the treatment of esophageal cancer have afforded better prognosis for patients. Despite the increased need to monitor the progress of patients with reconstructed digestive tracts over the long-term, no reliable prospective studies have yet been conducted. This prospective study determined secondary disease of the reconstructed gastric tube after esophagectomy for esophageal cancer.

Methodology: One hundred and fourteen patients who underwent esophagectomy and reconstructed gastric tube via the posterior mediastinal route between April 1992 and March 1999 at Akita University Hospital, were followed up. Follow-up endoscopy was carried out once a year to determine the incidence and characteristics of secondary disease of the reconstructed gastric tube.

Results: Fifty-four (47%) patients were found to have secondary gastric abnormalities. Of these, 4 patients (3.5%) had carcinoma of the gastric tube, 12 patients (10.5%) had benign gastric tumor, 7 patients (6.1%) had gastric ulcers, and 40 patients (35.1%) had erosive or hemorrhagic gastritis. Three patients found to have early gastric cancer upon periodic follow-up endoscopy underwent successful complete resections.

Conclusions: Annual follow-up endoscopy is vital to the detection of early, curative secondary gastric cancer and ulceration in patients following esophagectomy for esophageal cancer.