[Surgical treatment of esophageal cancer in post-subtotal gastrectomy patients].
Among the 1285 cases of esophageal cancer operated in our hospital during the interval 1985-1990, 11 had had subtotal gastrectomy earlier, with an incidence of 0.86%. Among these 11 cases, two had upper thoracic segment lesions which were resected and reconstructed by transverse and descending colon transplantation into the neck. Right postero-lateral thoracotomy, upper abdominal and left neck incisions were used. Nine patients had esophageal cancer in the middle and lower thoracic segment and 7 of them were operated by transplanting the remaining stomach with spleen and caudal portion of pancreas into the left thorax and esophago-gastrectomy with the remaining stomach. Exploratory thoracotomy only was done in the other 2 patients. No complication occurred. Billroth type II gastrectomy was found to be easier than Billroth type I to move the remaining stomach together with the spleen and pancreas up into the thorax and to anastomose supra-aortically. There was no direct cause-effect evidence between gastrectomy and the site of esophageal cancer. The purpose for gastrectomy (ulcer or cancer) and the type of gastrectomy (Billroth type I or II) were irrelevant to the subsequent development of esophageal cancer.
Yang
L
L
Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000601:surgery; D004947:Esophagus / Q000601:surgery; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013270:Stomach / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery; D013276:Stomach Ulcer / Q000601:surgery