A FUNDAMENTAL STUDY ON THE APPLICATION OF Nd : YAG LASER TO THE TREATMENT OF ESOPHAGEAL DISEASES

Abstract

A fundamental study on the application of YAG laser to the treatment of esophageal diseases was carried out using a dog, there was an obvious difference between the change of the esophaeal wall and the change of the gastric wall following laser irradiation: While the degeneration appeared first in mucosal side of the gastric wall, the degeneration appeared first in muscularis propria layer, then did in mucosal layer and in submucosal layer in esophageal wall. In esophageal wall, the irradiation with the energy which was small enough not to cause any change in mucosal layer when being irradiated in 90 degree angle, could cause the degeneration in mucosal side when being irradiated in smaller angle. The depth of the change of the wall immediately after the irradiation was estimated based on the endoscopic findings such as white elevation, white concavity of the surface and carbonized ulcer as the standard mark. It seems to be reasonable to consider that white concavity indicates the irreversible degeneration deep into the part of submucosal layer and that carbonized ulcer indicates the irreversible degeneration to proper muscle layer. The degree of the degeneration was severer when cancer in situ of human esophagus was irradiated after the sprinkling of 1 % Toluidine Blue than when irradiated without it. In both cases, the cancer lesion could be completely degenerated by the laser irradiation with the energy of 64W. The paper also reported on two cases of polyp in esophagogastric junction successfully treated with laser irradiation.