Daneker G W, Carlson G W, Hohn D C, Lynch P, Roubein L, Levin B
University of Texas M.D. Anderson Cancer Center, Houston 77030.
Arch Surg. 1991 Nov;126(11):1348-52. doi: 10.1001/archsurg.1991.01410350038006.
Patients with obstructing cancers are ineligible for preoperative chemotherapy and radiation unless they undergo surgical diversion. Endoscopic laser therapy (ELT) may provide an alternative to colostomy for these patients. We retrospectively reviewed all patients with distal sigmoid and rectal carcinomas who underwent ELT from January 1988 through April 1990. The majority of patients were referred for palliation of advanced disease. Thirty-seven patients underwent 123 ELT sessions (median, 2.5; range, one to 18). In 84% of patients, patency was maintained during a median follow-up of 31.5 weeks (range, one to 123). Morbidity and mortality were 2.5% (3/123) and 5% (1/37), respectively. Sixty-two percent had radiotherapy, chemotherapy, and/or surgery concurrent with ELT. Endoscopic laser therapy can safely and effectively reestablish and maintain luminal patency in patients with obstructing distal cancers. In addition, ELT can enable the administration of preoperative adjuvant radiotherapy and chemotherapy.
患有阻塞性癌症的患者不符合术前化疗和放疗的条件，除非他们接受手术改道。对于这些患者，内镜激光治疗（ELT）可能是结肠造口术的一种替代方法。我们回顾性分析了1988年1月至1990年4月期间接受ELT治疗的所有乙状结肠远端和直肠癌患者。大多数患者因晚期疾病的姑息治疗而就诊。37例患者接受了123次ELT治疗（中位数为2.5次；范围为1至18次）。在84%的患者中，在中位随访31.5周（范围为1至123周）期间保持了通畅。发病率和死亡率分别为2.5%（3/123）和5%（1/37）。62%的患者在ELT治疗的同时接受了放疗、化疗和/或手术。内镜激光治疗可以安全有效地重建并维持阻塞性远端癌症患者的管腔通畅。此外，ELT可以使术前辅助放疗和化疗得以实施。
