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PubMed1990

[Gastroscopy in follow-up studies of patients with chronic atrophic gastritis and diagnosis of early gastric cancer].

Visual assessment of gastric mucosa and histological findings in biopsies from the lesions were compared for 1806 patients with chronic atrophic gastritis. The spectrum of the focal lesions appeared wide. Morphological examinations determined basic comparable structural elements typical for atrophic gastritis. 85 patients were diagnosed to have early gastric cancer. All the cancer patients suffered from chronic atrophic gastritis and developed in 88% of cases intestinal metaplasia, in 32% severe epithelial dysplasia. Focal changes in the mucosa characteristic for early gastric cancer in 64% of cases could be considered as variants of chronic atrophic gastritis. In 52 patients cancer was identified during the follow-up, new-onset macroscopic alterations emerging in the last year in 62% cancer subjects. The rest of them had long-lasting macroscopic lesions, among them severe dysplasia of the epithelium in 65% of cases, believed to be histological variants of atrophic gastritis. Early cancer is suggested to develop in the presence of previous lesions rapidly and discretely.

Adult↗
PubMed1988

Gastroscopy: a primary diagnostic procedure.

EGD, using 1986 models of either the fiberoptic gastroscope or the videoscope, is a safe and accurate procedure that can be performed by any physician trained in the technique of endoscope passage. It may be performed at large medical centers or small rural hospitals, outpatient clinics, or even private offices. Patients themselves have indicated preference for endoscopic evaluation over the double-contrast barium meal after they have experienced both procedures. The short time of procedure, its accuracy, safety, and its relative lack of discomfort to the patient lend it readily to being an initial component in the primary evaluation of symptoms of abdominal distress, gastrointestinal bleeding, dysphagia, esophageal reflux, persistent vomiting, and odynophagia. It is essential in the evaluation of complications of esophageal reflux and the evaluation of abnormal radiological findings in the upper gastrointestinal tract. It should never be overlooked in evaluating the patient with iron deficiency anemia of unknown etiology. Economic pressures have already moved EGD from the surgery wards to endoscopy labs and to the outpatient setting. These same forces will project more physicians into the role of the diagnostic endoscopist and the patient will benefit by decreased medical costs, quicker diagnosis and treatment, and enhanced continuity of care.

Gastroscopes↗
PubMed1988

Retrograde intraoperative gastroscopy in obscure bleeding of the gastrointestinal tract.

Intraoperative endoscopic localization of the lesions responsible for the bleeding in the upper part of the gastrointestinal tract that escape detection in the preoperative period is an attractive alternative to the blind exploratory duodenogastrostomy. The retrograde technique described herein may be superior to the oral antegrade intraoperative method advocated by some authors. Large clots obscuring clear viewing are rapidly removed by way of the small gastrotomy, and the proximal hidden corners of the stomach are readily visualized even by a surgeon who lacks previous experience with endoscopic techniques. We suggest this to be the method of choice for localization of the obscure point of bleeding during emergent operations for bleeding of the upper part of the gastrointestinal tract.

Emergencies↗