PubMed · 3203253
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J Rudney. 1988. Rigid ureteroscopy.. https://pubmed.ncbi.nlm.nih.gov/3203253/
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Gastric cancer, the leading cause of death from cancer in Japan, has long been studied. We received our first patient with early gastric cancer in 1950 and have since treated 2382 patients with this cancer up to 1990. The percentage of early gastric cancers diagnosed has been on the increase following the improvement in diagnostic skills and the establishment of mass screening. At present, more than half of the gastric cancers presenting are in the early stages. Chronological changes in diagnoses of early gastric cancer are characterized by the increased findings of (a) small tumors less than 4 cm in diameter (b) depressed-type carcinoma (c) lesions of the upper part of the stomach, and (d) undifferentiated-type adenocarcinoma. The standard method of treatment for early gastric cancer was standard radical operation in the 1970s. In the 1980s endoscopic mucosal resection and limited operation were adopted and their use has been increasing annually. The prognosis for early gastric cancer is quite favorable (the 5-year survival rate is more than 90%), and it is regarded as a disease with good prognosis. To obtain still better therapeutic results, it is essential to increase the proportion of early gastric cancers where endoscopic mucosal resection or limited operation is indicated, and improve the techniques of those procedures.
Impaction of a fish bone at the base of tongue or the vallecula is a very common problem. Removal of the bone from these sites without a general anaesthesia can be challenging to surgeons and patients alike. Various manoeuvres to facilitate this procedure have been described, some are very successful but may require specialized instruments, while others may cause excessive discomfort to the patients and even inadvertent dislodgement of the bone. We describe a method using a flexible fibreoptic nasendoscope to provide a visual guide in order to facilitate peroral removal of the bone with a pair of forceps. This method is well tolerated by patients and avoids the need for a general anaesthesia in many cases.
We report on the case of a 63-year-old woman with a gastric stenosis caused by peritoneal carcinomatosis. Vomiting and nausea disappeared after the implantation of a self-expanding metal stent in the 5 cm-long stenosis, and the patient was able to maintain a normal diet. She was discharged from hospital and remained in good condition for 14 weeks. Then, 16 weeks after stent implantation, the patient died of metastatic tumor spread, having remained free of nausea and vomiting. An autopsy showed complete patency of the stent, and no signs of ulceration or tumor ingrowth. The success of the treatment in this patient suggests the importance of further investigations.