Sao Paulo Opening Ceremony:

Prof.Pinotti's Comment

Welcome to the 8th Congress of ISDE and thank you for your participation in the first Meeting of the new century, which will certainly be an important landmark in the history of Esophageal Congresses.
In the beginning of this new century all medical fields are growing very rapidly owing to progress in science and technology. This is also very true with esophageal diseases that are currently very common in all societies with some epidemiological peculiarities.

In tropical areas of South America ChagasÕ Disease affects 20 million people; in Brazil, 3 million and a half, approximately twenty percent of them with digestive consequences, among which three per cent have megaesophagus.

Schistozomiasis is another tropical disease common in Asia, Northern Africa and South America. In Brazil mainly in the Northern, and Central regions, there is high prevalence with three million people involved. Among them, 2,500 patients per year are hospitalized due to hepatic fibrosis and esophageal varices, with 500 deaths a year.
Cancer is considered the major esophageal pathology, due to its severity and mortality.

Heavy intake of distilled liquor with high alcoholic content and smoking habits are considered the most important factors in the development of esophageal cancer, especially when consumed in large amounts during long time. The behavior of the people in new societies and the promotion through the media are responsible for the uncontrollable consumption of both and their repercussions on the esophagus in the cancer development.

Certainly, in the near future researchers will achieve new methodological conquests that allow physicians to accomplish cancer diagnosis in early stages, particularly, through mass screening.

However, the most common esophageal disorder in all continents is reflux esophagitis. Population questromaires have shown that about 25% of people complain of heartburn symptom. One major challenge in this field is the columnar cell layer of the distal esophageal mucosa, the so-called BarrettÕs esophagus and its possibilities in cancer development. The great challenge is to know whether patients will have a benign or malignant outcome of this disease and certainly in the near future it will be possible for the physician to apply accurate diagnosis method, which will be hopefully answered in the near future, in the ISDE meetings.

'Finally, as a dreamer it is allowed to dream that the great dream is to get in the near future accurate diagnosis in all the diseases, mainly, malignant in early stages, definitely cured by advanced resources with fewer complications and without mortality'.

Prof.DeMeester,Prof.Ide,Prof.Watanabe,Prof.pinott,Prof.Lerut.

Delegates at the VIIIth World Congress.