The risk of invasive carcinoma in colorectal adenomas can only be adequately described by a complex model of the interactive effects of patient and adenoma characteristics on the main factors of size and site.

A multivariate analysis of 11,380 adenomas detected at the first total colonoscopy showed that the factors size and site, both of which can be assessed by endoscopic inspection alone, were found to enable a statistically and clinically adequate assessment of the malignancy risk.

We believe that PEG/PEJ represents an effective, minimally invasive, and cost-effective method for gastrointestinal decompression in patients with advanced incurable cancer.

During a 15-month period, a total of 11 patients underwent endoscopic application of fibrin tissue adhesive in the upper gastrointestinal tract. Our sample consisted of 6 patients with control of bleeding, 4 patients with management of anastomotic leaks, and one very old man undergoing prophylactic sealing of a chronic gastric ulcer with a visible vessel and repeated episodes of bleeding. The method described has proven to be successful in control of bleeding in every case and has resulted in quick cleaning of perianastomotic abscess cavities, growth of granulation tissue, and complete healing in 3 of 4 cases so far. This preliminary report suggests that fibrin adhesive application is effective in the control of oozing gastrointestinal bleeding and may support the healing process in difficult situations, such as chronic peptic ulcers and anastomotic leakages.

From 1961 to 1978, 113 patients with early gastric cancer were treated surgically at Erlangen University. The lesions were located in the lower 1/3 of the stomach in 47% of the patients, in the corpus and fundus in 46%, and in the gastric stump after resection in 7%. Surgical techniques included subtotal distal resection, proximal resection, total gastrectomy, local excision and polypectomy, and their use depended on the circumstances. The tumors were classified as intestinal type carcinoma in 71% of patients and diffuse type carcinoma in 29%. The 5-year survival rates calculated by the actuarial method were 74% (observed) and 87% (age corrected). Tumors in the lower 1/3 of the stomach had a better prognosis than tumors of other regions. Tumors limited to the mucosa had a higher 5-year survival rate than those with invasion of the submucosa. In Europe, as in Japan, early gastric cancer has a much better prognosis than all other forms of gastric cancer.