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[Early diagnosis of stomach neoplasms].

The primary prevention of the carcinoma of the stomach promises little success in near future. Therefore the effort is directed to early recognition and healing (secondary prevention). The optimum method for this is the combination of X-ray-examination, gastroscopy and aimed biopsy. But also by early diagnosis and therapy in the invasive carcinoma the chances of survival are to be improved. At present only 5-6% of the patients with gastric carcinoma survive longer than 5 years. The author adopts a definite attitude to the groups with risk of carcinoma. The search for further factors of persons endangered by carcinoma (habit of nutrition, kind of constitution and preparation of food, other exogenous factors) must be continued intensively in order to get selected groups which may be controlled consequently.

Biopsy

[Cytologic diagnosis of stomach neoplasms].

Personal experience in the cytological diagnosis of gastric neoplasis acquired in a series of 104 patients is presented. Three false positives were detected in 29 cases of supposed malignancy and 11 false negatives in 75 patients with tumours thought to be benign. Cytology often proved the determining factor in the planning of surgery, while in some instances it also gave an indication of the histological type involved.

Adenocarcinoma

[The value of laparoscopy within the framework of standardization of the diagnosis of stomach neoplasms].

Today the operative treatment of the carcinoma of the stomach is methodically mature. The prognosis is determined from the moment of the extension of the tumour. The establishment of the operability and of the tactical operative approach presumes an exact preoperative determination of the stage of the tumour using all possible diagnostic methods. While X-ray examination of the stomach and gastroscopy seize only the extension of the area of the tumour, the laparoscopy gives the possibility of an evidence of the deep growth of the tumour and metastasizing of the tumour and saves a test laparotomy for inoperable patients. A continuous interdisciplinary cooperation renders possible an immediate admission of the patient to a surgical clinic.

Adult