It was shown that the stent described here can be implanted without major problems. The greater effort of the implantation procedure, in comparison with self-expanding stents, is compensated by the special mechanical characteristics of the stent. These characteristics may permit implantation in anatomically difficult locations where up to now stenting has been impossible or inadequate.
The use of stenting devices in children to treat benign esophageal strictures is safe and efficient. The self expanding plastic stents had the best long term results but required high compliance of parents and children due to the tendency of stent migration. Self expanding nitinol stents are more traumatic at the extraction procedure and are useful in patients with low compliance. Recurrence of strictures occurred most often after esophageal tubi possibly due to the lack of radial expansion.
Early endoscopy in the upper alimentary tract after surgical operations on the stomach reveals multifarious diagnostic and therapeutic possibilities to give decisive help to patients when applied critically and rationally. The possibilities of endoscopy can differentiate between active and arrested bleeding episodes, can induce hemostasis, can diagnose and overcome sutureline insufficiencies, can differentiate the different kinds of stenosis in the lower esophageal junction. It can treat postoperative atony, diagnose perforation at an earlier stage, localize obstructive jaundice, remove intestinal foreign bodies and characterize unexpected postoperative histological findings.
Cytological smears from 779 cases were examined over a three-year period, cell collection and cytological diagnosis being in separate hands (material sent in from outside). Three quarters of the cytological findings could be compared with the histological diagnosis: 68% of 194 histologically proven malignant tumours were diagnosed cytologically. The diagnostic accuracy varied between 53 and 74.4%, depending on experience and precision of the endoscopist. In 18 cytologically positive cases results were different from the histological diagnosis. Initial diagnosis of malignant tumour by cytology was made in 3.6% of cases. Subsequently repeated biopsies or histological examination of surgical specimens confirmed the diagnosis.
134 outpatients with acute benign gastric ulcer confirmed by endoscopic biopsy received either 1 g sucralfate suspension four times daily or one 150 mg ranitidine tablet twice daily for six to 12 weeks in a multicentre therapy study (double-blind study according to the double-dummy technique). After six to 12 weeks, respectively, 56% and 82% of the ulcers had healed in the sucralfate group. The rates of healing in the ranitidine group were 72% and 88%, respectively. The differences in the rates of healing between sucralfate and ranitidine were not statistically significant. Ranitidine was superior to the sucralfate suspension in corpus ulcer. In the distally located ulcers, the two kinds of treatment were equivalent. There were no appreciable differences between the medications with regard to antacid consumption and compliance. Gastric pain was influenced better by ranitidine than by sucralfate.
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