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Biomedical subjects

M Savary

Publications and source records attributed to M Savary.

At least 91 records · Page 5Linked to original sources
PubMed1975

[Cancer of the esophagus and cardia: diagnostic problems].

For many decades, the problem of cancer of the esophagus has been dominated by constant failure in diagnosis and therapy. Today the widespread use of upper digestive endoscopy could seem to constitute, for the moment, the only hope of changing this situation. Leaving aside the clinical, radiological, and enoscopic symptomatology of invasive esophageal cancer, this study is limited to practical considerations on the technology of endoscopic diagnosis in esophageal cancerology; the endoscopic expression of carcinoma "in situ" and chronic irritative esophageal condition; the precancerous and early-stage symptomatology of cancer of the esophagus; and the problem of "pseudo-cancer" of the esophagus.

Biopsy↗
PubMed1975

[Endobrachyesophagus and adenocarcinoma].

During 6168 esophagoscopies (ENT Clinic, Medical School of Lausanne and Hospital of Yverdon: 1963-1974), 164 cylindrical epithelial patches (26%) have been detected endoscopically with a regular progressive incidence from year to year (optical improvement, interest and progressive training of endoscopists). Endoscopically, a distinction can be drawn between: 1. the cylindrical epithelial islets of the upper (19%) or lower (4%) esophagus; 2. widespread cylindrical epithelial lining of the lower esophagus (77%). The first type cannot be associated in any significant manner with any organic pathology. It is of congenital origin and is, as a rule, without pathological significance. Statistically, however, the second type would seem to enter into the category of peptic esophagitis in its chronic form, and appears to constitute a form of cicatrization. The incidence of adenocarcinoma of the lower esophagus in association with this second form of cylindrical epithelial lining is significant. It would, therefore, be advisable for peptic esophagitis to be treated before it reaches its chronic stage and, in particular, before the appearance of cylindrical epithelial scars.

Adenocarcinoma↗
PubMed1975

Columnar-lined lower esophagus: an acquired lesion with malignant predisposition. Report on 140 cases of Barrett's esophagus with 12 adenocarcinomas.

The analysis of a series of 1,225 cases of reflux esophagitis shows the serious nature of this condition. A liberal use of antireflux operations therefore seems justified. Extensive columnar metaplasia of the distal esophagus, or columnar-lined lower esophagus (CLLE), represents a late irreversible stage of reflux esophagitis. Repeated esophagoscopies demonstrate the acquired nature of the lesion. It is caused by the progressive healing, from below upward, of peptic ulcerations on the squamous epithelium by metaplasia of columnar mucosa. Antireflux operations stop the progressive ascent of heterotopic epithelium and thus stabilize reflux esophagitis and cure complications such as ulcerations and strictures. The premalignant character of this condition is established by a 10 per cent incidence of adenocarcinomas in a series of 140 cases of extensive columnar metaplasia. The transition toward malignancy seems to be irreversible and cannot be arrested by an antireflux operation. Therefore, repeated esophagoscopic controls and biopsies are an absolute necessity in all cases of extensive columnar metaplasia, even after cure of active reflux esophagitis by Nissen fundoplication.

Adenocarcinoma↗