Maeta M, Koga S, Shimizu N, Hamazoe R, Inoue Y
First Department of Surgery, Tottori University School of Medicine, Yonago, Japan.
J Surg Oncol. 1988 Jul;38(3):143-6. doi: 10.1002/jso.2930380303.
Between 1965 and 1985, 89 Japanese patients with esophageal squamous cell carcinoma underwent esophagectomy. In five of them (5.6%), a simultaneous metastatic lesion from the esophageal cancer was detected within the stomach in the resected specimens. Preoperative diagnosis of the gastric lesions had been made in none of the five patients because of an obstruction that was due to esophageal cancer. All gastric lesions were located at the gastric cardia, close to the esophagocardial junction, with a mean distance of 6.9 +/- 2.0 cm from the primary esophageal lesions. Provision of a gastric tube that contains metastatic lesions, for reconstruction of a new alimentary tract after esophagectomy, must be avoided. In cases of inadequate preoperative gastric examination, gastric lesions should be searched for intraoperatively, not only by serosal inspection and palpation, but also by mucosal inspection and palpation after partial proximal gastrectomy.
1965年至1985年间，89例日本食管鳞状细胞癌患者接受了食管切除术。其中5例（5.6%）在切除标本中发现胃内同时存在来自食管癌的转移病灶。由于食管癌导致的梗阻，这5例患者术前均未对胃部病变做出诊断。所有胃部病变均位于胃贲门，靠近食管-心肌交界，距原发性食管病变的平均距离为6.9±2.0厘米。必须避免使用含有转移病灶的胃管来重建食管切除术后的新消化道。在术前胃部检查不充分的情况下，术中应不仅通过浆膜检查和触诊，还应通过近端胃部分切除术后的黏膜检查和触诊来寻找胃部病变。
