Ferraro P, Beauchamp G, Aumais G
Division of Thoracic Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, PQ.
Can J Surg. 1990 Dec;33(6):479-82.
Between May 1985 and December 1988, 41 patients were treated palliatively with endoscopic neodymium:yttrium-aluminum-garnet laser therapy for obstruction of the esophagus by malignant disease. All were considered incurable, because they presented with distant metastases, severe systemic disease, extensive local disease or recurrent disease. Thirty-nine percent were managed as outpatients; the remainder required admission to hospital. Sixty-three percent of the outpatients had adenocarcinoma, and 31% had squamous cell carcinoma; over 90% of the tumours were less than 8 cm long, and 63% were in the distal one-third of the esophagus or the cardia. Forty-four percent of the inpatients had adenocarcinoma, and 44% had squamous cell carcinoma; in this group, over 90% of the tumours were less than 8 cm long, and 56% were in the distal one-third of the esophagus or the cardia. The mean number of sessions and laser energy administered were 2.6 and 4949 J for outpatients and 2.7 and 4974 J for inpatients. Palliation of dysphagia was good to excellent in all outpatients but was not as good for the inpatient group, in which one major complication occurred. The mean length of survival for outpatients and inpatients was 6.3 months (range from 1 to 16 months) and 3.9 months (range from 1 to 18 months) respectively.
1985年5月至1988年12月期间，41例因恶性疾病导致食管梗阻的患者接受了内镜下钕：钇铝石榴石激光姑息治疗。所有患者均被认为无法治愈，因为他们出现了远处转移、严重的全身疾病、广泛的局部疾病或复发性疾病。39%的患者作为门诊患者接受治疗；其余患者需要住院。门诊患者中63%患有腺癌，31%患有鳞状细胞癌；超过90%的肿瘤长度小于8厘米，63%位于食管远端三分之一或贲门处。住院患者中44%患有腺癌，44%患有鳞状细胞癌；在这组患者中，超过90%的肿瘤长度小于8厘米，56%位于食管远端三分之一或贲门处。门诊患者接受治疗的平均次数和激光能量分别为2.6次和4949焦耳，住院患者为2.7次和4974焦耳。所有门诊患者吞咽困难的缓解情况良好至极佳，但住院患者组的情况则没那么好，该组发生了1例严重并发症。门诊患者和住院患者的平均生存时长分别为6.3个月（范围为1至16个月）和3.9个月（范围为1至18个月）。
