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Basic and clinical research on intramural esophagography
Authors:M Akaike
Affiliation:First Department of Surgery, Yokohama City University School of Medicine, Japan.
Abstract:Preoperative diagnosis of the penetration of esophageal cancer is important in its treatment. Lipiodol Ultra Fluid was injected into the oral side of the lesion, and after consideration of the state of its transfer linearly and histologically, the contrast medium had mostly transferred into the spaces between tissue. As a preoperative method of diagnosis, the ratio of the distance of transfer from the proximal edge of the tumor to the distal edge of the tumor in relation to the vertical length of the tumor was calculated and called the transfer ratio, and also (1) the distance from the assumed edge of tumor to the projecting portion in the inner cavity for the deepest part of the tumor was calculated, as was (2) the same calculation for the greatest penetration of contrast medium in the layer of adventitia, and the transfer ratio was multiplied by (2)/(1) and the result was called the section ratio. Using the transfer ratio and the section ratio, the preoperative depth of the invasion by the esophageal cancer was classified into four classifications: A0(sm), A0(pm), A1-2, and A3. The accuracy of diagnosis, comparing the preoperative diagnosis and the histological examination was: A0(sm): 100%, A0(pm): 75%, A1-2: 91.7%, A3: 80% and was 85.7% overall, showing very good result.
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