Schultheis K H, Meyer W, Havardt M, Dokmetzioglou J, Schönekäs H, Gebhardt C
Abteilung für Gastroenterologie, Städtischen Klinikums Nürnberg.
Zentralbl Chir. 1990;115(7):419-32.
Between Jan. 1, 1986 and March 31, 1988 a total of 128 patients with tumours of the colon and rectum were treated by Nd-Yag laser at Nürnberg City Hospital. There were 36 benign and 92 malignant lesions. The indications for laser therapy were stenosis, bleeding, spasms of the pelvic floor and increased mucous production. Initial control of these problems could be achieved in 105 patients (82%), however, the symptoms recurred in 50% of the malignant and 47% of the benign tumours. Complications of laser treatment were encountered in 13 patients necessitating an operative intervention in 6. In all, 34 patients underwent additional surgery after laser treatment. Most frequently, a diverting colostomy had to be provided (n = 18) while 12 patients underwent anterior resection; in three an abdomino-perineal resection was performed and in one patient a Hartman procedure was necessary. The median observation time of patients with benign tumours is, at present, 16 months with 72% being free of disease. In malignant tumours the median survival time of patients with laser therapy only is 4.5 months; those with additional surgical treatment survived a median of 17.5 months.
1986年1月1日至1988年3月31日期间,纽伦堡市立医院共有128例结肠和直肠肿瘤患者接受了Nd-Yag激光治疗。其中有36例良性病变和92例恶性病变。激光治疗的适应证为狭窄、出血、盆底痉挛和黏液分泌增多。105例患者(82%)的这些问题得到了初步控制,然而,50%的恶性肿瘤和47%的良性肿瘤症状复发。13例患者出现了激光治疗并发症,其中6例需要进行手术干预。总共有34例患者在激光治疗后接受了额外的手术。最常见的是需要进行转流性结肠造口术(n = 18),12例患者接受了前切除术;3例患者进行了腹会阴联合切除术,1例患者需要进行哈特曼手术。目前,良性肿瘤患者的中位观察时间为16个月,72%的患者无疾病。在恶性肿瘤中,仅接受激光治疗的患者中位生存时间为4.5个月;接受额外手术治疗的患者中位生存时间为17.5个月。