Mide Ülserli Hastalarda Endoskopi Tekrarı Akılcı Bir Yaklaşım mı?

Authors : Murat Saruç, Deniz Böler, Mehmet Karaarslan, Ümit Ince, Kemal Raşa, Cihan Uras, Metin Çakmakçi, Nurdan Tözün

Pages : 35-37

View : 56 | Download : 15

Publication Date : 2010-03-01

Article Type : Research

Abstract :Aim: It is well established to repeat endoscopy in patients with gastric ulcers to diff erentiate malign ulcers from benign ones. In clinical practice it is not always easy to convince patients for repeated endoscopies. Gastroenterologists must have evidence based indications to off er a patient second endoscopy. We aimed to evaluate our repeat gastroscopy indications, fi ndings and yield.Methods: We included the patients who underwent repeat endoscopy to assess ulcer healing and exclude malignancy in our center within 12 months duration. They were evaluated for the fi nal diagnosis, numbers of endoscopic procedure to reach the exact diagnosis, and endoscopic and pathological fi ndings. All patients were examined by same endoscopist.Results: In this period 83 patients with gastric ulcer underwent repeat gastroscopy. Average numbers of endoscopy was 2.15. In nine patients, 3 gastroscopy procedures were needed wheras only two patients were in need of fourth gastroscopy and no one needed fi fth. Seventy-seven of 83 patients were ulcer free at repeat endoscopies. But 6 7.2% patients were shown to have malignant ulcers. Four of them were diagnosed after second endoscopy but two patients’ malignancies could be diagnosed at the third third procedure. Five of the patients had gastric adenocancer and the other single case had gastric lymphoma. Two of 5 40% adenocancers were early gastric cancer.Conclusion: Our study re-enforced the recommendation that all patient with gastric ulcers should undergo repeat endoscopy to exclude malignancy. The malignancy rate was 7.2% in our cases. This high rate must encourage clinicians and endoscopist to insist on repeating endoscopy to assess ulcer healing
Keywords : gastric ulcer, gastric cancer, gastric early cancer, endoscopy, repeat gastroscopy