Effect of surgical treatment of primary cardiac and esophageal carcinoma of remnant stomach / 中华胸心血管外科杂志

ABSTRACT

Objective To report the surgical treatment results of cardiac and esophageal cancer of remnant stomach. Methods From 1980 to 2002, 30 patients with cardiac and esophageal cancer of remnant stomach were treated surgically. Results Primary cardiac and esophageal carcinoma of remnant stomach developed in male patients more than females. Of 30 patients, 21(70%) underwent subtotal gastrectomy with Billroth II reconstruction at first time. The mean interval between two operations was 13.5 years. Clinical symptoms frequently included abdominal distension, pain and hemorrhage. Thirty patients received radical resection. Conclusion Cancer in remnant stomach should be suspected in patients undergoing subtotal gastrectomy 5 years and over have clinical symptoms of upper gastrointestinal tract. Early diagnose and early curative resection should be done. For cardiac cancer of remnant stomach, total gastrectomy with “P” loops and Roux-en-Y esophagojejunostomy reconstruction were recommended. This procedure have advantage in retaining enough food storage preventing reflux esophagitis and allowing resection of esophagus long enough to avoid cancer remnant. For esophageal cancer of remnant stomach, colon reconstruction after the resection of esophageal cancer is recommended.