[Modern surgical treatment of breast cancer. 3rd Breast Cancer Consensus Conference].

Therapy for breast cancer today is characterised by ever more precise diagnostic methods and ever more effective oncological treatments, a trend which will certainly continue into the future. Breast preservation and the application of oncoplastic principles are increasingly popular. A sentinel lymph node biopsy in the surgical treatment of the axilla is primary, with the indication for axillary block dissection (ABD) narrowing and radiation therapy becoming an alternative to ABD in certain cases.

[3rd Hungarian Breast Cancer Consensus Conference - Surgery Guidelines].

Therapy for breast cancer today is characterised by ever more precise diagnostic methods and ever more effective oncological treatments, a trend which will certainly continue in the future. Breast preservation and the application of oncoplastic principles are increasingly popular. A sentinel lymph node biopsy in the surgical treatment of the axilla is primary, with the indication for axillary block dissection (ABD) narrowing and radiation therapy becoming an alternative to ABD in certain cases.

[Surgical management of non-palpable breast tumors].

Due to the improvement of the diagnostic and screening methods for detecting breast cancer (e.g. mammography, breast ultrasonography, MR imaging, FNAC, core biopsy or vacuum-assisted core biopsy), non-palpable breast masses are more and more commonly discovered.

The place of gastro-jejuno-duodenal interposition following limited esophageal resection.

Objective: Although stomach is the best choice for reconstruction after esophagectomy from the viewpoint of safety and ease, an intrathoracic stomach, nevertheless, is a poor long-term substitute. This anatomical configuration abolishes normal antireflux mechanisms and places the acid-excreting stomach subject to biliary reflux, moreover, in an adjacent position to the esophagus within the negative-pressure environment of the thorax.

Methods: Between 1995 and 2002, 27 patients with high-grade neoplasia-as early Barrett's carcinoma-or non-dilatable peptic stricture underwent limited surgical resection of the distal esophagus and esophagogastric junction.

Synchronous multiple glomus tumors of the esophagus and lung.

A case of synchronous esophageal and multiple pulmonary tumors presenting complex diagnostic problems is described. In the course of routine pulmonary screening a pulmonary coin lesion of the right lung and three very small foci on the left side, under the pleura falling just within the range of diagnostic parameters was identified in a symptom-free patient. In addition to the multiple lung lesions a single sub-mucosal esophageal tumor was detected.

[Role of functional investigations in gastrointestinal surgery].

The understanding, complex analysis and extensive knowledge about the physiology of the gastrointestinal tract are bases of functional and reconstructive surgery. We present our routine physiological tests. Several clinical syndromes may be related to motility disorders of the esophagus, stomach, colon and the anal sphincter apparatus.

[Rare late complication after subtotal esophagectomy].

We report a case of a peptic ulcer developed in the stomach tube used for the replacement of the esophagus. The patient was a 60 years old female who had undergone subtotal esophagectomy for mid esophageal malignancy, with intrapleural stomach replacement. Urgent endoscopy revealed an excavated, bleeding ulcer in the thoracic part of the stomach.

[Perspectives of laparoscopy in cardia and gastric surgery].

The authors have made 171 laparoscopic operations in the gastro-esophageal region during the past three and a half years. They have used the achievement of the minimal invasive surgery mainly in the treatment of functional diseases of the gastro-esophageal junction. Besides the hiatal reconstruction and antireflux procedures (142), endoscopic assisted cysto-gastrostomy (7), endoscopic assisted double-lifting gastric wall resection (5), cardiomyotomy (4), Graham suture of perforated duodenal ulcer (4) and enucleation of gastric wall leiomyoma (2) has been performed.

[Esophageal anastomosis--based on the experience with 1460 operations].

The authors reviewed the clinical records of 1460 patients with esophageal anastomoses, the operations performed in their institute between 1973 and 2000. Surgical outcome was assessed with incidence of anastomotic leaks and overall mortality. Hand-sewn anastomoses were performed by inserting single layer interrupted monofil steel wire (507), PDS (232) or Vicryl (65) sutures and circular stapler (EEA, Ethicon) was used in 656 patients.

Metastasis of an esophageal carcinoma to a giant gastric ulcer.

In patients with esophageal carcinoma it is considered that stomach metastasis is induced mainly via the lymphatic route rather than via the bloodstream route that is common in other types of distant organ metastasis. A 56 year-old patient is reported who underwent synchronous subtotal esophagectomy and total gastrectomy for a middle third esophageal carcinoma and a giant peptic ulcer within the gastric fundus. The final histopathologic examination revealed a squamous cell carcinoma of the esophagus with concomitant squamous tumor implantation within the gastric ulcer.