Non-surgical radical treatment of early gastric cancer by endoscopic contact Nd-YAG laser: report of a case.

A case of flat-elevated type (IIa) early gastric cancer completely eradicated with contact Nd-YAG laser is reported. The patient was diagnosed as having early gastric cancer (type IIa) by endoscopic examination. Biopsy revealed a well-differentiated adenocarcinoma. He declined surgery and subsequently received 4 sessions of contact Nd-YAG laser treatment with a total output of 1245 watt-sec. An ulceration was created by the end of the third session of laser treatment. He finally agreed to surgery and a subtotal gastrectomy was performed after completion of four sessions of therapy. Meticulous histologic examination of the resected specimens revealed no residual cancer cells. This is the first report of endoscopic curative treatment of gastric cancer by contact Nd-YAG laser in Taiwan. This technique may provide an alternative for patients with early gastric cancer, who have a high surgical risk.