Inorder to determine the operative indications of three-field lymph node dissection of esophageal cancer, attempts were made to collect data concerning procedures performed between 1983 and 1989 in major institutions in Japan, and the results from institutions performing three-field or two-field lymph node dissection were compared. The treatment results of three-field lymph node dissection were better than those after two-field dissection, except for early or advanced cancer. The survival rate improved by the three-field as compared with the two-field lymph node dissection; however,, since surgery was invasive, some complications such as recurrent nerve paralysis were frequent. The results show that the indication of three-field lymph node dissection has to be carefully determined for each patient.

No abstract

Statistics on the causes for deaths of 638 patients operated on in our department for resection of cancer of the intrathoracic esophagus (squamous cell carcinoma) during the period from 1959–1979 showed that the major causes for direct operative deaths were pyothorax, pulmonary complications, failure of the sutures, and postoperative hemorrhage. Among operation survivors, recurrence was the most frequent cause of death, responsible for the deaths of as many as 80% of less‐than‐five‐year survivors; and recurrence in the cervical, supraclavicular fossa, and superior mediastinal lymph nodes and that in the other organs were the frequent causes for the deaths of two‐ to three‐year survivors. Pulmonary complications were the causes for the deaths of 50%, and recurrence for the deaths of 30% of five‐ to ten‐year survivors. Recurrence in the digestive organs other than the esophagus and cardiovascular diseases were the frequent causes for the deaths of more‐than ten‐year survivors, while none of these survivors died of recurrence.

more than one year if the lesion was less than 5 cm, 21% if it was between 5 to 8 cm, and 9% if the lesion was from 9 to 13 cm in size. However, the size of the three groups was not

An endoscopic dyeing method with methylene blue solution was described for an accurate and safe diagnostic dyeing of cancer and intestinal metaplasia in the stomach, after washing the surlace of gastric mucosa with proteinase. An introduction of methylene blue into the stomach 2 hours before endoscopy, selectively dyed the cancer and the intestinal metaplasia a dark blue. Normal gastric mucosa, the margin and scar of gastric ulcer, erosion, benign polyp and gastritis without intestinal metaplasia remained undyed.This method was performed on 77 gastric lesions and 33 (92°/o) of 36 gastric cancers have been successfully dyed. In all 24 cases, biopsy specimens from dyed areas confirmed the presence of severe intestinal inetaplasia; and from undyed areas, at/ ophic mucosa without intestinal metaplasia. The endoscopic close-up views of dyed lesions showed the different patterns between the cancer and the intestinal metaplasia. This finding allows the differential diagnosis between them. Fresh frozen sections by cryostat of the specimens from dyed areas showed histologically staining of the superficial cells of the cancerous lesions and the intestinal metaplasia. Endoscopic examination of gastric lesions dyed with methylene blue solution provides the endoscopist with an excellent method of identifying early cancer and intestinal metaplasia of the stomach. Key-Words: Endoscopic dyeing method, early gastric cancer, intestinal metaplasia, vital staining of gastric lesions. Recently in gastroscopy, great efforts have been made for detection of minute lesions of the gastric mucosa, especially early gastric cancer with an excellent fibergastroscope. However, it is often very difficult to recognize such a small lesion even by an experienced endoscopist. Therefore, every endoscopist Endoscopy 5 (1973) 124-129 C) Georg Thieme Verlag, Stuttgart Endoskopisdm Färbemethode zur Diagnostik von Friihkarzinom und intestinaler Metaplasie des Magens Nach Beseitigung des wandadhärenten Magenschleims durch eine Proteinasenl6sung lassen sich Karzinom und intestinale Metaplasie mit Methylenblau anfärben, wenn die Schleimhaut für zwei Stunden dem Farbstoff exponiert wird. Normale Schleimhaut, Ulkusrand, Erosionen, Polypen und Gastritis ohne intestinale Metaplasie färben sich nicht an. Diese Metliode wurde bei 77 Magenläsionen angewandt; von 36 Magenkarzinomen fiirbten sich 32 (92%) an. Bei allen 24 Fallen von intestinaler Metaplasie konnte die Diagnose bioptisch aus den angefärbten Arcaico gesichert werden. Die Nahbetrachtung gestattet eine sichere Differenzierung zwischen Karzinom und intestinaler Metaplasie. In Gefrierschnitten aus den intravital gefärbten Schleimhautpartien konnte eine Anfärbung der oberflächlichen Zellen bei Karzinom und intestinaler Metaplasie dokumentiert werden.used to have a dream in which the minute early cancer might be stained selectively by a dye, and could be easily detected under gastroscopic observation. Fortunately, we were almost succeeded in realizing this dream with dyeing gastric lesions by using methylene...