[Prevalence of Barrett's esophagus in patients with colorectal carcinoma]. / Prevalencia de esófago de Barrett en pacientes con carcinoma colorrectal.

OBJECTIVE: To determine Barrett's esophagus (BO) prevalence in patients diagnosed with colorectal carcinoma (CC) and feasibility-associated factors in a 10 week period from March 1st to June 15, 1999. PLACE: Endoscopy Department, Oncology Hospital, Centro Médico Nacional Siglo XXI, IMSS. METHOD: A prospective, transversal, observational and comparative assay of 48 patients with histologically confirmed diagnosis of colorectal carcinoma in whom high endoscopy with biopsy harvest was performed; otherwise, colonoscopy was performed in eight patients with confirmed BO. RESULTS: Thirty men and 18 women were studied with an average age of 53 years of age. In 100%, colon cancer was determined as adenocarcinoma and location were rectal in 43.7%. Prevalence of BO was 22.9% in addition to 0.74 to 2% in the general population. This implies an odds ratio calculated at 36.43 (p = 0.00000) and 3.09 p = 0.00007), respectively, for risk to present BO concomitant with CC. There was no statistical significance in relation to age, smoking habit, and/or alcoholism. Among eight patients with BO without CCR, only one had a tubulovellous polypus (12.5%) identified. CONCLUSIONS: Although the results were not to conclusive to affirm the association of BA with CCR, the high prevalence found justifies the performance of routine endoscopy in CCR carrier patients with reflux symptoms.

[Esophageal prosthesis]. / Prótesis esofágicas.

The patient with advanced esophageal cancer (AEC) is condemned to a short existence. The management of the majority of these patients is only palliative. The results obtained with surgery, radiotherapy and chemotherapy are only slightly encouraging. The patients require a highly effective palliative treatment that resolves the dysphagia, and the endoscopic procedures have demonstrated their high effectiveness. The principal objective is to better the quality of the life of the patient. Advantages of the Endoscopic Procedure (EP): this is carried out in only one session, does not require hospitalization, is low in cost, resolves the dysphagia, is well tolerated, the morbidity-mortality is low, and it is useful in esophagobronchial fistulas. Disadvantages: greater morbidity, is not useful in cervical esophagus, fluoroscopy is indispensable, it requires skill and experience, and the prosthesis can migrate. We report here on the insertion of 31 non-expandable polyvinyl EPs in patients with (AEC) (15.7% of 197 cases of(AEC) diagnosed in 4 years 5 months); 21 males (67.74%) and 10 females (32.25%); the average extension of the obstructed segment was 6.06 cm, and was localized in 77.41% in the inferior third; 64.51% were adenocarcinomas, and 32.25% were epidermoid carcinoma; five carcinomas (16.1%) originated in the Barrett esophagus; the complications were the following: migration 3 (9.67%), perforation 2 (6.45%), and obstruction by food 1 (3.22%). The dysphagia was resolved in all of the patients.

[Esophageal prosthesis]. / Prótesis esofágicas.

Esophageal carcinoma has a very poor prognosis instead its histological type. Survival at 5 years is below 15%. With the prosthesis there is a change in the quality of life, but not in prognosis. We present our experience and make point in the correct techniques.