[Malignant esophageal-respiratory fistula and esophageal stenosis treated with a Gianturco-Z-stent]. / Malignus oesophagorespiratoricus fistula és nyelöcsöstenosis kezelése Gianturco-Z-stenttel.

Oesophago-respiratory fistula in most instances in a complication of advanced malignant tumours of the oesophagus or the lung. In our patient group eleven oesophago-respiratory and one gastro-respiratory fistulas were encountered. Three patients were operated upon. In one of them with achalasia, early oesophageal carcinoma was discovered in the background of the fistula. Two patients had fistulas without of oesophageal narrowing, therefore, stent implantation into the trachea and bronchus was performed. One of them was previously managed endoscopically with lyodura plug and fibrin glue, but only temporary occlusion of the fistula was obtained. In five patients, seven conventional oesophageal prosthesis (6 Cook, 1 Rüsch) were used to close the fistulas. In one of these patients, three oesophago-respiratory fistulas developed one after the other at the level of the prosthesis funnel. They were closed with three prostheses connected with short silicone tubes. In the last two patients, Gianturco-Z stent was employed. Its advantages over the plastic prostheses include small basic and lager final luminal diameter, lesser predilatation, easier implantation, lower complication and mortality rate. The silicone coated and double funnel stent with expansile force is effective in fistulas closure. On implantation, stent shortening in minimal, allowing precise placement of the stent even in proximal malignant oesophageal stenosis with oesophago-bronchial fistula. The high price of the stent is compensated for by the lower complication rate, shorter hospitalization and subsequent reduction is hospital expenses. Therefore these metal stents should be financed by the National Health Service, at least in specialized centers for managing patients with dysphagia.

[Use of the Preci-Horix attachment in anchoring an overlay denture]. / Preci-Horix egyedi felhasználása overdenture rögzítésében. Esetismertetés.

In the case report the overdenture prosthesis replacing the subtotal edentulousness is fixed by a Preci-Horix anchorage of individual design built on the tooth roots. The matrix portion of the anchorage was built in situ into the tooth plate of the denture. This aimes at preventing the disadvantageous overloading effect of the position change due to initial sinking of the denture on the support tooth.