Evaluation of endosonography in TN staging of oesophageal cancer

Article Abstract:

Cancer of the esophagus is a disease with a very poor prognosis for survival: five years after diagnosis, between 90 and 96 percent of the patients have died. The only cure for esophageal cancer is surgical removal of the tumor, but this can only be carried out in selected cases. Those cases in which there is infiltration of the esophageal musculature by the tumor are considered to be inoperable, and only palliative treatment (to reduce pain and keep the patient comfortable) is administered. The remainder of the cases should undergo surgical treatment as soon as possible. To avoid unnecessary surgery, accurate determination of the degree of tumor infiltration is necessary. Currently used methods, such as computed tomography (a technique for visualizing internal structures), often fail to correctly diagnose the stage of the cancer. To evaluate the usefulness of endosonography (visualization of the esophagus and stomach by means of a flexible ultrasound probe inserted into the esophagus), a study was carried out with 52 patients suffering from esophageal cancer. Patients underwent both computed tomography and endosonography for diagnosis of their condition. Thirty-seven of these patients had subsequent verification of the degree of esophageal involvement either during surgery or at autopsy. Endosonography correctly identified the stage of the cancer in 89 percent of the patients with early-stage cancer and 69 percent with late-stage, compared with 51 percent for both types when evaluated with computed tomography. These significant improvements in accuracy with endosonography show that it is a useful tool in the diagnosis and evaluation of esophageal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Cancer, Esophageal cancer, Cancer diagnosis, Diagnosis, Ultrasonic, Diagnostic ultrasonography

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Effect of cisapride on delayed gastric emptying in gastro-oesophageal reflux disease

Article Abstract:

In normal swallowing, an esophageal wave of relaxation and contraction propel liquids and solids down the esophagus to the gastroesophageal sphincter, which briefly relaxes, allowing the ingested material to enter the stomach. The sphincter closes immediately, preventing reflux of the highly acidic gastric contents into the esophagus. In some individuals, impaired control of the esophageal and gastric musculature causes reflux of the gastric contents, resulting in inflammation and damage to the esophagus (gastroesophageal reflux disease). It is known that some patients with gastroesophageal reflux disease have delayed emptying of liquids or solids (or both) from the stomach. To assess the role of cisapride, a drug that promotes gastrointestinal motility and gastric emptying, on the gastric function of patients with gastroesophageal reflux disease, a study was carried out with 34 patients between the ages of 18 and 81 years of age who were suffering from this condition, and who showed evidence of delayed gastric emptying of solids. Baseline gastric emptying rates were determined, and patients were then randomly given either oral cisapride three times a day for three days or similar treatment with a placebo. Following cisapride administration, gastric emptying rate (as determined by the amount of radioactively labelled solid nutrient remaining in the stomach after 100 minutes) was significantly increased compared with the placebo. The acceleration of gastric emptying was largely caused by increased motility of the proximal portion (the part nearest the esophagus) of the stomach. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Gastrointestinal system, Gastroesophageal reflux, Cisapride, Gastrointestinal motility

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