[Digestive tract tumors after gastrectomy of peptic ulcer]

In a series of 160 patients submitted to esophageal resection because of cancer, four cases were found who have been partially gastrectomized for benign stomach or duodenal ulcer decades ago (2.5%). An other similar case was detected by endoscopy and aimed biopsy. In the sixth patient, the cancer developed simultaneously in the gastric remnant and in the distal jejunum loop after partial gastrectomy of Billroth--II. type. Two esophageal cancers of the above-mentioned four resected specimens, were in the T1 stage according to TNM classification of UICC. One tumour of the later two esophageal carcinomas did not reveal any clinical sign. The patient had at the same time early invasive cancer in the gallbladder and synchronously a renal cell carcinoma in the left kidney. The main clinical symptoms of the last patient could be attributed to the gallstone disease. The esophageal carcinomas that developed after partial gastrectomy did not show any difference neither in localization, in the macro- or in the microscopical features nor in the chronic esophagitis and epithelial dysplasia in comparison with other esophageal cancer of patients who were not submitted to partial gastrectomy. Attention must be called to the significance of reflux-esophagitis which can occur with partial gastrectomy. The follow-up of such patients is doubly important if the forceps biopsy detected epithelial dysplasia in the esophagus. On the other hand, the reconstruction of HIS-angle during partial gastrectomy is very important in the prevention of reflux-esophagitis.