Anatomic and pathological aspects in the pathology of malignant gastric tumors.

Efforts in perfecting the methods of early diagnosis, in trying to assess premalignant conditions, and in properly staging malignant tumors are still in trend. The geographic area around Timisoara (Banat Region) is situated on the first place in the country as far as the gastric location of cancer is concerned. The authors aimed to deal with the initial stage in the development of gastric cancer, a stage which has been oncologically termed "precancerous damage", and with the neoplastic invasion of the gastric wall. The present paper is based on the 1995-2005 statistics of the IInd Surgical Department of the Timisoara County Hospital, the study group consisting of 802 patients admitted for gastric disorders, 522 of which being later diagnosed with a tumoral pathology. Routine morphological tests were conducted on biopsy pieces dye stained with Hematoxylin-Eosin, standard technique, the van Gieson trichromic staining, the Giemsa staining, the AA-PAS staining and the immunoreaction methods. The age for gastric tumoral pathology ranged between 36-88 years in females, and 31-87 years in males. Most gastric carcinomas are adenocarcinoma, 404 (90%) cases--could be classified as follows: 167 cases of tubular adenocarcinoma; 39 cases of papillary adenocarcinoma; 24 cases of mucinous or colloid adenocarcinoma; 141 "signet ring"-cell carcinoma; 33 cases of undifferentiated carcinoma. Currently there is an increase of the incidence of the "diffuse"-type in women and at younger ages. Attention should be given to precancerous conditions; there was a large number of premalignant or potentially malignant gastric damage: atrophic chronic gastritis (54 cases), intestinal metaplasia (104 cases), and gastric dysplasia (104 cases).

[Benign esophageal strictures--outcomes of coloesophagoplasty in Surgical Clinic II Timisoara]. / Stenozele benigne ale esofagului --rezultate ale reconstructiei esofagiene cu colon în Clinica a II-a Chirurgie din Timisoara.

Esophagoplasty is obviously a proper choice of treatment; postoperative outcomes should be very good because of benign type of lesions, but morbidity-mortality are high due to the complexity of the intervention. Our purpose is to emphasize the utility of coloesophagoplasty like a very feasible surgical option, based to our short and long term outcomes. This paper relies on the retrospective analysis of all cases admitted to II-nd Surgical Clinic Timisoara in a 20 years period (1983-2002), having coloesophagoplasty for benign esophageal stenosis. There were performed 45 such interventions (16 men, 29 women); the mean age was 35.7 years (15-68 years). The pathology included postcaustic lesions (42 cases), peptic lesions (2 cases) and esophageal leiomyoma (1 case). Postoperative morbidity occurred in 22.6% of patients. The graft functionality was good and very good in 86.6% of patients at discharge. Postoperative mortality was 6.6%.