Effect of tumour and chemoradiotherapy on oesophageal motility.

BACKGROUND: The contribution of dysmotility to dysphagia in oesophageal cancer is unclear. AIM: To examine oesophageal motility in patients with oesophageal carcinoma and to assess the effect of chemoradiotherapy on motility. METHODS: Stationary manometry and 24-hour pH-metry were performed in 12 patients with oesophageal carcinoma and one week following completion of chemoradiotherapy using 5-fluorouracil (5-FU), cisplatin and 40Gy radiotherapy. RESULTS: All patients had abnormal motility prior to treatment. Peristalsis was impaired in 11 patients with a mean (SD) of 25% (9) of waves normally propagated. Eight patients had 20% or more simultaneous waves. Following chemoradiotherapy, the percentage of waves normally propagated increased from 25% (9) to 521% (10) (p < 0.03) and normal peristalsis was restored in four patients. The percentage of simultaneous waves decreased from 38% (11) to 21.6% (10) (p = 0.129) while the percentage of dropped or increased waves decreased from 20% (11) to 8.3% (4) (p = 0.264). CONCLUSIONS: Oesophageal motility is disturbed in oesophageal cancer. Dysphagia in oesophageal cancer may be partly explained by oesophageal dysmotility. This is improved by chemotherapy.

[Pancreatic pseudocysts (ultrasonic location data and their morphology at different periods of occurrence)]. / Pankreaticheskie psevdokisty (dannye ul'trazvukovoi lokatsii i morfologiia v razlichnye periody sushchestvovaniia).

The work makes parallels between findings of ultrasonic location and the morphology of pancreatic pseudocysts in different periods of their existence. According to results of a histological investigation the pseudocysts can be divided into those being formed (less than 3 months of their existence), formed (more than 3 months of their existence) and isolated ones (after 1-1.5 years). Each period has its peculiar picture of the ultrasonic investigation. The wall of the forming pseudocysts is not dense enough for performing the internal drainage, external drainage having the worst immediate and long-term results. So, the pseudocysts must be operated upon during the 13th-16th weeks of their existence. The isolated pseudocysts are removable, but waiting for this period is not possible because of the probability of extremely dangerous complications.

[Importance of ultrasonic echolocation in the differential diagnosis and observation of the development of pancreatic pseudocysts]. / Znachenie ul'trazvukovoi ékholokatsii v differentsial'noi diagnostike i nabliudenii za razvitiem psevdokist podzheludochnoi zhelezy.

Under observation there were 84 patients with pseudocysts of the pancreas, in 12 of them the main diagnostic method was ultrasonic echolocation. The differential diagnosis between the cyst and tumor was sometimes difficult. The most characteristic sign of the disintegrating tumor was a considerable and irregular thickening of the wall of the cavitary formation found. In four cases repeated ultrasonic examinations in dynamics made it possible to register the involution of pseudocysts which took place within 3-4 weeks after the onset of the disease.