Clinical Application of Endoscopic Laser Therapy in Gastrointestinal Disese: Especially in early gastric cancer

Choi, Seok Reyol

Abstract

I tried the endoscopic laser therapy for the malignant and benign disease of the alimentary tract to evaluate efficacy in rejection of surgical treatment or inoperable state. I have experienced 16 cases of the laser therapy in my hospital from July 1990 to June 1991. The apparatus I used is the SLT contact Nd-YAG laser with the ceramic endoprobe of rounded or chisel or hollow type in each case. The irradiation was made at an output of 15-20 Watts within 1.5 seconds. Between the 2-4 weeks laser therapy, the treatment response was observed by rebiopsy, I treated 7 cases of early gastric cancer and post-laser follow-up study showed 70% negative for cancer cells by endoscopic biopsy. Failure of laser treatment was found in case of IIc type, Two cases of advanced gastric and I case of rectal cancer with severe obstruction were relieved by laser therapy. I also experienced 3 cases of esophageal or gastric polyp which were completely. resolved after irradiation. Besides, I could get hemostasis in 1 case of gastric ulcer bleeding with exposed vessels and 1 case of Mallory-Weiss syndrome. And a case of gastric bezoar was completely fragmentated after irradiation. As mentioned above, I achieved satisfactory results of 13 cases in 16 cases. Contact Nd - YAG laser treatment ean be applicated with excellent efficacy in any age, sex and severity of disease with or without complications and any site of lesions which can be reached within the endoscope. I suggest it is maybe highly promising medical technique in the future.