Yang L
Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Zhong Liu Za Zhi. 1992 Sep;14(5):371-4.
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.
在1985年至1990年间于我院接受手术治疗的1285例食管癌患者中，有11例先前接受过胃大部切除术，发生率为0.86%。在这11例患者中，2例为胸上段病变，采用横结肠和降结肠移植至颈部进行切除和重建。采用右后外侧开胸、上腹部和左颈部切口。9例患者为胸中段和下段食管癌，其中7例通过将残余胃连同脾脏和胰腺尾部移植至左胸并进行残余胃食管胃切除术进行手术。另外2例患者仅行开胸探查术。未发生并发症。发现毕Ⅱ式胃切除术比毕Ⅰ式更容易将残余胃连同脾脏和胰腺向上移入胸腔并在主动脉弓上方进行吻合。胃切除术与食管癌部位之间没有直接的因果关系证据。胃切除术的目的（溃疡或癌症）和胃切除术的类型（毕Ⅰ式或毕Ⅱ式）与随后食管癌的发生无关。
