Abstract
Since 1982, we have been using the Nb: YAG laser endoscopically to treat 104 patients with malignant stricture of gastrointestinal cancers. Those cases consisted of 21 esophagus, 42 cardia, 4 body, 14 antrum, 11 stoma, and 9 colorectum, and the functional success was seen in 78%, 72%, 33%, 57%, 62%, and 83% respectively. The length of time requiring no hospitalization (outpatient period) accounted for 4 weeks or more, or accounted for 30% or more of the remainder of patient's life after laser therapy, was seen in 56% of esophagus, 64% of cardia, and 50% of antrum.
As to the survival time, there was statistically no significance between the laser and non-curative resection groups both in cardia and in antrum. In addition to that, the median value of outpatient period was 17 weeks of the laser and 3 weeks of the chemotherapy group (p<0.05) in cardiac obstruction, and 8 weeks of the former and 0 week of the latter (p<0.01) in antral obstruction.
We conclude that Nd:YAG laser therapy for malignant gastrointestinal stricture should be applied to a patient who is unable to operate because of such factors, as high risk or distant metastasis.
