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A Study on Radiological Diagnosis for the Esophageal Infiltration of the Cardio-Esophageal Carcinoma S. Inuo 1 , T. Sannohe 1 , M. Hirano 2 , K. Sugimachi 2 , T. Nakamura 2 , K. Inokuchi 2 12nd Department of Surgery, Faculty of Medicine, Fukuoka University 22nd Department of Surgery, Faculty of Medicine, Kyushu University pp.209-217
Published Date 1975/2/25
DOI https://doi.org/10.11477/mf.1403112160
  • Abstract
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 In the surgical resection of cardiac carcinoma involving the esophagus we have to decide whether it should be done under thoracotomy or by way of the abdomen alone. In the light of the macroscopic type and length of cancer infiltration of the esophagus and in order not to leave any cancer nests in the esophageal remnant, we have considered it necessary to resect the uninvolved part of the esophagus 2 cm oral from the uppermost tip of cancer infiltration when it is proximally localized and 4 cm oral when it is not localized.

 Prerequisite prior to such an operation means thorough roentgenological knowledge of the types and length of the uppermost part of esophageal infiltration. Generally speaking, however, cardio-esophageal cancer is mostly so far advanced that simple visualization of the chief lesion alone is often considered sufficient during fluoroscopy and too little attention is paid to the photographic method most suitable for the delineation of esophageal cancer itself. In the light of this fact we have devised various procedures to depict to the best advantage cancer infiltration from the lower esophagus to the gastric orifice. We have chosen the lateral position with the body bent down ward to the utmost (bowing from the waist) according to Matsuura as well as the concept of Okamoto et al. regarding a few slender smooth and regular lines at the mucosa of gastric orifice, and especially be right or left recumbent lateral position cancer infiltration is well demonstrated in double contrast picture against the background of the fornix amply insufflated with air. By this means we are now able to raise the positive rate of x-ray confirmation hitherto low of the macroscopic types of esophageal infiltration up to 30 per cent and of its length to 25~40 per cent.


Copyright © 1975, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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