Endoscopic treatment of praecancerous colorectal lesions and early colorectal cancer.

Endoscopic mucosal resection or piece meal polypectomy are the methods of choice for the treatment of unifocal visualized lesion. Thermal ablative techniques are indicated for flat adenomas as a adjunct therapy after an imcomplete EMR or piece meal polypectomy. Photodynamic therapy using ALA photosensitisation is effective in the treatment of multifocal lesions and also in combination with EMR or thermal ablative techniques. At present, the "tailored suite" combination of these techniques for each patient, according to the character of the lesions, is considered to be the most effective treatment of precancerous lesions and early colorectal cancer (Tab. 1, Fig. 2, Ref. 16). Full Text (Free, PDF) www.bmj.sk.

[Triple combination antimicrobial therapy of Helicobacter pylori and basal levels of serum gastrin]. / Trojkombinacná antimikróbna liecba Helicobacter pylori a bazálna hladina sérového gastrínu.

BACKGROUND: The etiopathogenic relationship of Helicobacter pylori (HP) infection to chronic active antrumgastritis and peptic ulcer disease has been confirmed by a number of studies. The key role in the development of peptic lesions belongs to hypergastrinemia. This is supposed to be related to ammonium synthesis in the antral area influenced (promoted by HP and resulting in interruption) weakening of the negative feedback mechanism maintaining intraluminal acidity. OBJECTIVES: In our present study we focus our attention to the effectiveness of triple antimicrobial therapy in HP positive patients with chronic active antrumgastritis residing in the lowering of the level of serum gastrin. METHODS: There was a group of 15 patients in our current study with HP positivity as well as chronic active antrumgastritis documented by endoscopy, histology, microbiology and serology respectively. Endoscopical and histological findings were classified according to "The Sydney System". The whole group was evaluated on an ambulatory basis, those with active ulcer, endocrinopathy and biliary tract disorders were excluded. The basal level of serum gastrin was evaluated by RIA-test-gastrin before and after successful antimicrobial therapy. RESULTS: In our group of 15 patients with HP infection in coexistence with chronic active antrumgastritis we have found a significant decrease in the basal level of serum gastrin (p = 0,01) after successful therapy. CONCLUSION: The decrease in the basal level of serum gastrin after eradication of HP confirms the importance of HP infection in the pathogenesis of peptic lesions in stomach and duodenum. We consider the antimicrobial therapy in chronic active antrumgastritis in HP positive patients to be a fully indicated therapeutic approach. (Tab. 1, Fig. 1, Ref. 10.).

[Colonoscopy monitoring intervals after polypectomy of adenomas of the large intestine in patients younger than 40 years of age]. / Intervaly kolonoskopických kontrol po polypektómii adenómov hrubého creva u pacientov mladsích ako 40 rokov.

A group of patients younger than 40 years of age, who had been subdued to endoscopic large intestine adenoma polypectomy were compared with the rest of the patients regarding the adenoma occurrence according to sex, localisation, histologic character, frequency of recurrence, and carcinoma formation in the large intestine in the site of previous polypectomy. The compared groups of patients differed merely in time of recurrence. In patients over 40 years of age the adenomas reoccurred most frequently in the first and fifth years following the primary polypectomy. In patients after primary polypectomy regular colonoscopic controls were suggested, namely after the first year and subsequently after every two years. This scheme is appropriate also for patients under the age of 40 years. Therefore the recommended intervals of colonoscopic controls at this age category do not require to be subdued to alteration. (Tab. 14, Ref. 5.)