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At least 577 records · Page 32Linked to original sources
PubMed1990

[Esophageal tube in inoperable esophageal and cardia cancer: indications and technique].

Endoscopic tube implantation remains still one of the alternatives in palliation of inoperable patients with malignant stenosis of the esophagus and cardia. Although LASER-treatment has less complications, patients in poor general condition, patients with tracheo-esophageal fistulas, patients with external compression of the esophageal lumen, are clear indications for tube implantation. The right choice of palliative technique should depend on the individual situation of the patient.

Cardia↗
PubMed1990

[Cervico-mediastinal inflammatory pseudotumors due to esophageal perforation by foreign bodies].

Two patients suffered from superior mediastinal masses producing pain and dysphagia. They were investigated using imagery and endoscopy without a definite diagnosis being made. It was finally decided to perform a cervical exploration in both cases and this enabled a diagnosis of perforation of the oesophagus and pseudo-tumoral abscess to be made. The foreign body responsible was found in one case. The symptoms and signs of oesophageal perforation by foreign body may be misleading when they are chronic or delayed. There remains a place for surgical exploration when other methods have failed.

Abscess↗
PubMed1979

[Endoscopy of the esophagus, stomach and duodenal bulb].

The authors report on the position of the endoscopy of oesophagus, stomach and duodenal bulb within the diagnostic endoscopy. The therapeutic endoscopy including polypectomy remains widely not taken into consideration. They particularly deal with the endoscopic-bioptic diagnosis of the stenoses of the oesophagus, the gastric ulcers and the early carcinoma of the stomach. It is referred to the importance of the endoscopy for the diagnostics of varicose veins of the oesophagus and of duodenal ulcers. For the clinician references to the clinical elaboration of the endoscopic and bioptic findings are given.

Digestive System Diseases↗
PubMed1994

[A randomized clinical study of preoperative accelerated radiotherapy versus routine radiotherapy for late esophageal cancers--an analysis of 177 cases].

From March 1989 to Oct. 1993, 177 patients with esophageal cancer were treated with preoperative radiotherapy. They were randomly divided into two groups: preoperative routine radiotherapy (RR) group and accelerated radiotherapy (AR) group. In the former group, radiation was given 2 Gy/day, 5 sessions/week with a total of 40Gy in 4 wks, while in the AR group, radiation was given 2 Gy/session, two sessions/day at an interval of 6-8 hours, 10 sessions/week for 2 weeks with a total dose of 40 Gy in 2 weeks. The patients were operated 3-4 weeks after radiation. The resectability rate was 95% in AR group, and 90% in RR group. The 1-, 2-, 3- and 4-year survival rates in AR group were 89%, 85%, 69% and 60%, while 80%, 65%, 48% and 41% in RR group respectively. The degree of tumor regression examined histopathologically was: Grade I in 9%, Grade II in 41% and Grade III in 50% of AR-treated patients, while in 34%, 39%, 27% of RR-treated patients. Periesophageal lymph node metastasis was 13% in AR group, while 24% in RR group. The results of AR are better than that of RR indicate that preoperative accelerated radiation gave better therapeutic results than routine radiotherapy.

Adult↗
PubMed1996

[Personal experience with palliative endoscopic treatment of stenoses in the upper gastrointestinal tract].

The authors discuss the endoscopic approach to stenoses in the area of the oesophagus and cardia in patients with contraindication of radical surgery. They describe the method of treatment with regard to the type and character of the stenosis. The work is based on 10 years experience with palliative endoscopic treatment of benign and malignant stenoses of the upper GIT. During this period more than 800 dilatations were made, 150 oesophageal prostheses were introduced and during the past two years 25 metallic stents.

Cardia↗
PubMed1996

[Therapeutic effect of argon plasma coagulation on small malignant tumors of the gastrointestinal tract].

The use of argon plasma coagulation has proved to be an effective method of non-contact electrocoagulation with high efficiency in palliative treatment of gastrointestinal lesions. In this study there were 10 patients suffering from small oesophageal malignant tumors; in 5 patients no further tumor could be detected in biopsies during a period up to 34 months, in the other cases passage could kept open. These results suggest this treatment as an alternative therapy in selected patients.

Biopsy↗
PubMed1996

[Endoscopic treatment of anastomosis insufficiency and perforation in the esophagus with fibrin glue].

The incidence of anastomotic dehiscence following oesophageal or gastric resection reported in European studies varies between 3.5 and 25%. The outcome of these patients is usually not explained nor is there a relevant number of studies concerning the treatment of this situation. Oesophageal perforation is rare but is commonly combined with high morbidity and mortality. Operative treatment mostly means major surgical procedures. In our institution endoscopic treatment of these defects has been established since 1985. Following the endoscopic diagnosis, the extent of the defect becomes radiologically documented by filling the cavity with contrast media. This also shows any contact to intraoperatively placed drainages. The lesions and abscess cavities are then endoscopically flushed with saline solution on a daily basis analogously to an internal drainage until surfaces are cleansed. Developing granulation tissue and cleansed surfaces are then covered with fibrin tissue adhesive to support shrinking of the defect. During the last 9 years, we treated 46 cases of anastomotic dehiscence and 9 oesophageal perforations applying this regimen. About 50% of the patients showed signs of sepsis at the beginning of their course. The defects were between 1 and 400 ml in size. In a median number of 4 (1-19) endoscopies a median of 8 (1-81) ml of fibrin tissue adhesive was applied. The average costs for fibrin tissue adhesive were about US $720. Close to 80% of the lesions could be healed, only 14% of the patients developed oesophageal stenosis with a consecutive need of dilatation. We therefore conclude that this method is helpful in treating patients with oesophageal lesions, especially if they are in reduced general condition and are at high risk for operative interventions.

Esophageal Neoplasms↗
PubMed1997

[Value of the esophagogram in preoperative assessment of esophageal carcinoma].

PURPOSE: In this study we utilized barium swallows exhaustively in each patient. After that we compare the results with the intraoperative findings. The goal is to select those criteria which contribute to the preoperative clinical staging of esophageal carcinoma. METHODS: In a retrospective study we examined the esophagograms of 65 tumor patients. We evaluated the location and length of the tumor, the deformation of the esophageal axis, stenosis, dilatation, and the radiological type of the tumor. All characteristics were correlated with the pathologically determined TNM-criteria, the stage of the tumor, and the palliative or curative type of resection. RESULTS: We found the following significant correlations: localisation/T-criterion, radiological type/T-and M-criteria, stenosis/type of resection, deformation of the axis, stenosis and radiological type/tumor stage. CONCLUSION: In the sense of a checklist the stenosis, the deformation of the esophageal axis and the radiological type of the tumor should be carefully evaluated and included in the report. With these data, the clinical stage of the tumor can be estimated.

Adenocarcinoma↗
PubMed1976

Recurrent esophageal obstruction due to squamous cell carcinoma in a horse.

Squamous cell carcinoma involving the pars esophagea of the stomach caused recurrent esophageal obstruction in an 11 year old Pinto gelding. The tumor encircled the esophagus and was attached to the diaphragm, spleen, aorta, left adrenal gland and kidney. Definitive diagnosis was provided by biopsy of the mass via standing left flank laparotomy.

Animals↗
PubMed1998

Role of endoscopic ultrasound in the preoperative assessment of patients with oesophageal cancer.

Despite encouraging results from Europe and America, endoscopic ultrasound (EUS) has yet to become established in the United Kingdom. The aims of this prospective study were to investigate its value in the assessment of patients with benign and malignant oesophageal conditions, and in particular to assess its reliability for local tumour (T) and lymph node (N) staging in patients with oesophageal cancer. EUS was performed in 90 patients: 23 were normal controls, 17 had benign oesophageal diseases and 50 had operable oesophageal cancer. Detailed measurements of the oesophageal wall and regional nodes were made and the accuracy of EUS for locoregional tumour staging was compared with final histology. EUS visualised the normal oesophageal wall as a multilayered structure, thicker distally than proximally. Distal stenotic conditions caused thickening of the proximal wall and loss of this gradient. EUS was highly accurate for both local tumour (92% correct) and lymph node staging (86% correct) and was better than computed tomography, magnetic resonance imaging and open staging performed by the surgeon. Fine needle aspiration biopsy using radial scanning EUS guidance was shown to be feasible. EUS is a valuable technique for investigation of both benign and malignant oesophageal conditions. It provides highly accurate local tumour and regional lymph node staging data in patients with oesophageal cancer.

Endosonography↗
PubMed1996

Use of sonography in the evaluation of the gastroesophageal junction.

To demonstrate the gastroesophageal junction with a real-time, transabdominal sonography through the window of left lobe of liver, the normal sonographic pattern and the thickness of the wall of abdominal esophagus were determined. The detection rate of the normal pattern in 30 control subjects was 93%, the normal thickness of the wall being 3.8 +/- 1.2 mm (range 2 mm to 5 mm). In 7 patients with severe acute esophageal inflammation, the thickness was 7.6 +/- 2.1 mm (range 5 mm to 10 mm). In 6 patients with an invading lesion in the gastroesophageal junction due to malignancy, the thickness of the wall was more than 10 mm in each case. This preliminary study indicates that the sonographic detection of gastroesophageal junction through the liver window can be included in routine abdominal sonography. An increased thickness of the wall needs further study to find the cause of the thickening.

Acute Disease↗
PubMed1995

Esophageal replacement: gastric tube or whole stomach?

BACKGROUND: The stomach can be used either in its entirely or as a greater curvature tube for esophageal replacement. METHODS: The study compares the gastric tube (group A; n = 112) to the whole stomach whose lesser curvature is denuded (group B; n = 100) in terms of technical complication and alimentary comfort. The clinical results are substantiated by assessment of the eating performance of patients and control subjects at a test meal, measurement of the gastric dimensions before and after both tailoring procedures, and intraarterial staining of the gastric wall. RESULTS: Major differences between the two groups are cervical anastomosis stenoses (22.3% versus 6% [A versus B]; p = 0.008), fistulas (7.9% versus 1%; p = 0.0209), number of meals and snacks per day (4.6 versus 4; p = 0.0275), sensation of early fullness at meals (52.4% versus 17.8%; p < 0.0001), ratings given to the long-term alimentary comfort (presymptomatic condition = 10 points) (7.6 versus 8.8 out of 10 on average; p < 0.0001), and calories consumed in 1 minute at a test meal (59% [p < 0.05] versus 77% of those consumed by control subjects). The volume of the stomach is reduced by a range of 21.4% to 47.2% after tubulization (group A) whereas it increases by a range of 4.9% to 17.4% after denudation of the lesser curve (group B). Intraarterial staining of the gastric wall reveals the poor vascularity of the upper-most segment of the greater curve. CONCLUSION: Slight increase of the gastric capacity and maintenance of the submucosal vascular network account for the better results achieved with the whole stomach.

Adolescent↗
PubMedDate not supplied

Double versus single contrast gastrointestinal radiology.

With experience, air contrast examination of the esophagus, stomach, and duodenum can be performed routinely as quickly and easily as the standard UGI. The air contrast examination is superior for detection of small gastric polyps and the Japanese have found it superior for detection of early carcinoma. The postoperative stomach and the fundus and cardia are most easily examined by air contrast. Clear superiority in the diagnosis of peptic ulcers and peptic esophagitis has not been proved. The most accurate routine examination may be a multiphasic or combined approach utilizing air contrast views as well as filled compression views and careful fluoroscopy. With respect to the colon, we do not suggest that air contrast BE must be done exclusively. However, it is superior for the detection of polyps and small carcinomas. The technique should be available in all radiology departments and should be an integral part of the evaluation of patients at increased risk of developing carcinoma. This includes patients over 40 years of age, with chronic ulcerative colitis, familial multiple polyposis or Gardner's syndrome, family history of inherited cancer, and medical history of adenomatous polyps, colorectal cancer, or female genital cancer. In addition, air contrast enema should be utilized for the sensitive and accurate evaluation of early inflammatory bowel disease. Finally, with respect to the colon examination one fact must be stressed. Irregardless of full column or air contrast method, most missed lesions are due to poor bowel preparation, poor technique, or perceptive error by the radiologist. There can be no substitute for a clean colon, meticulous attention to technical details, and careful review of the radiographs.

Air↗
PubMed1993

Chemoprevention of oral leukoplakia and chronic esophagitis in an area of high incidence of oral and esophageal cancer.

This intervention trial carried out in Uzbekistan (former USSR) in an area with a high incidence of oral and esophageal cancer involved random allocation of 532 men, 50 to 69 years old, with oral leukoplakia and/or chronic esophagitis to one of four arms in a double-blind, two-by-two factorial design, with active arms defined by the administration of (a) riboflavin; (b) a combination of retinol, beta-carotene, and vitamin E; or (c) both. Weekly doses were 100,000 IU of retinol, 80 mg of vitamin E, and 80 mg of riboflavin. The dose of beta-carotene was 40 mg/d. Men in the trial were followed for 20 months after randomization. The aim of the trial was to determine whether treatment with these vitamins or their combination could affect the prevalence of oral leukoplakia and/or protect against progression of oral leukoplakia and esophagitis, conditions considered to be precursors of cancer of the mouth and esophagus. A significant decrease in the prevalence odds ratio (OR) of oral leukoplakia was observed after 6 months of treatment in men receiving retinol, beta-carotene, and vitamin E (OR = 0.62; 95% confidence interval (CI): 0.39 to 0.98). After 20 months of treatment, no effect of vitamin supplementation was seen when the changes in chronic esophagitis were compared in the four different treatment groups, although the risk of progression of chronic esophagitis was lower in the subjects allocated to receive retinol, beta-carotene and vitamin E (OR = 0.65; 95% CI: 0.29 to 1.48) A secondary analysis not based on the randomized design revealed a decrease in the prevalence of oral leukoplakia in men with medium (OR = 0.45; 95% CI: 0.21 to 0.96) and high (OR = 0.59; 95% CI: 0.29 to 1.20) blood concentrations of beta-carotene after 20 months of treatment. Risk of progression of chronic esophagitis was also lower in men with a high blood concentration of beta-carotene, odds ratios being 0.30 (95% CI: 0.10 to 0.89) and 0.49 (95% CI: 0.15 to 1.58) for medium and high levels, respectively. A decrease in risk, also statistically not significant, was observed for high vitamin E levels (OR = 0.39; 95% CI: 0.14 to 1.10). These results were based on levels of vitamins in blood drawn after 20 months of treatment.

Aged↗