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Article: Esophageal cancer in patients with a history of distal gastrectomy

TitleEsophageal cancer in patients with a history of distal gastrectomy
Authors
Issue Date2002
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 2002, v. 137 n. 11, p. 1238-1242 How to Cite?
AbstractHypothesis: There is an association between a history of distal gastrectomy and the development of esophageal cancer. Surgical treatment of esophageal cancer in patients with a history of gastrectomy is more complicated but will not result in increased mortality in an experienced center. Design: Case-control study. Setting: Tertiary care center for the treatment of esophageal cancer. Patients: Forty patients with a history of gastrectomy and 1266 patients with intact stomachs who underwent esophagectomy for cancer. Main Outcome Measures: Patients' demographic characteristics, tumor characteristics, operative morbidity, mortality, and long-term survival. Results: There were more squamous tumors located in the lower third of the esophagus in those who had a history of gastrectomy compared with those with intact stomachs (16 [41%] of 40 patients vs 318 [25%] of 1266 patients; P = .04). This difference was more pronounced after Billroth I vs Billroth II gastrectomy (8 [73%] of 11 patients vs 8 [29%] of 28 patients; P = .03). Twenty-four patients (60%) in the gastrectomy group and 738 (58%) in the nongastrectomy group underwent surgical resection (P = .87). The operative time (300 [160-465] vs 220 [90-520] minutes; P<.001) was longer and more blood loss (1000 [300-2500] vs 700 [150-7000] mL; P<.001) was encountered for esophagectomy after previous gastrectomy (data are given as median [range]). A colon interposition was the substitute conduit of choice in the gastrectomy group (20 [83%] of 24 patients), and the stomach was the preferred loop in those with intact stomachs (729 [99%] of 738 patients). Postoperative complication rates were similar. In-hospital mortality rates also did not differ for those with a history of gastrectomy vs those without such a history (12% for both, P>.99). Median survival after resection was 13.8 and 12.5 months for patients who did and did not undergo prior gastrectomy, respectively (P = .62). Conclusions: A history of gastrectomy (especially the Billroth I type) is associated with more lower-third squamous cell esophageal carcinomas. Surgical resections in patients with such a history were more complicated but resulted in similar outcomes.
Persistent Identifierhttp://hdl.handle.net/10722/83376
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAlexandrou, Aen_HK
dc.contributor.authorDavis, PAen_HK
dc.contributor.authorLaw, Sen_HK
dc.contributor.authorWhooley, BPen_HK
dc.contributor.authorMurthy, SCen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:40:18Z-
dc.date.available2010-09-06T08:40:18Z-
dc.date.issued2002en_HK
dc.identifier.citationArchives Of Surgery, 2002, v. 137 n. 11, p. 1238-1242en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83376-
dc.description.abstractHypothesis: There is an association between a history of distal gastrectomy and the development of esophageal cancer. Surgical treatment of esophageal cancer in patients with a history of gastrectomy is more complicated but will not result in increased mortality in an experienced center. Design: Case-control study. Setting: Tertiary care center for the treatment of esophageal cancer. Patients: Forty patients with a history of gastrectomy and 1266 patients with intact stomachs who underwent esophagectomy for cancer. Main Outcome Measures: Patients' demographic characteristics, tumor characteristics, operative morbidity, mortality, and long-term survival. Results: There were more squamous tumors located in the lower third of the esophagus in those who had a history of gastrectomy compared with those with intact stomachs (16 [41%] of 40 patients vs 318 [25%] of 1266 patients; P = .04). This difference was more pronounced after Billroth I vs Billroth II gastrectomy (8 [73%] of 11 patients vs 8 [29%] of 28 patients; P = .03). Twenty-four patients (60%) in the gastrectomy group and 738 (58%) in the nongastrectomy group underwent surgical resection (P = .87). The operative time (300 [160-465] vs 220 [90-520] minutes; P<.001) was longer and more blood loss (1000 [300-2500] vs 700 [150-7000] mL; P<.001) was encountered for esophagectomy after previous gastrectomy (data are given as median [range]). A colon interposition was the substitute conduit of choice in the gastrectomy group (20 [83%] of 24 patients), and the stomach was the preferred loop in those with intact stomachs (729 [99%] of 738 patients). Postoperative complication rates were similar. In-hospital mortality rates also did not differ for those with a history of gastrectomy vs those without such a history (12% for both, P>.99). Median survival after resection was 13.8 and 12.5 months for patients who did and did not undergo prior gastrectomy, respectively (P = .62). Conclusions: A history of gastrectomy (especially the Billroth I type) is associated with more lower-third squamous cell esophageal carcinomas. Surgical resections in patients with such a history were more complicated but resulted in similar outcomes.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.titleEsophageal cancer in patients with a history of distal gastrectomyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=137&issue=11&spage=1238&epage=1242&date=2002&atitle=Esophageal+cancer+in+patients+with+a+history+of+distal+gastrectomyen_HK
dc.identifier.emailLaw, S: slaw@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLaw, S=rp00437en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid12413309-
dc.identifier.scopuseid_2-s2.0-0036850020en_HK
dc.identifier.hkuros83719en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036850020&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume137en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1238en_HK
dc.identifier.epage1242en_HK
dc.identifier.isiWOS:000179090900005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridAlexandrou, A=12760653800en_HK
dc.identifier.scopusauthoridDavis, PA=7403509648en_HK
dc.identifier.scopusauthoridLaw, S=7202241293en_HK
dc.identifier.scopusauthoridWhooley, BP=6602989930en_HK
dc.identifier.scopusauthoridMurthy, SC=7202013138en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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