The impact of an endoscopic laser service on gastroenterological practice.

During the 18 months following the introduction of a neodymium yttrium aluminium garnet laser in Newcastle upon Tyne 48 patients were treated, 23 for haemorrhage from peptic ulcers or vascular anomalies of the gut and 25 for palliation of inoperable tumours of the oesophagus, stomach and rectum. The treatment was tolerated well and was effective both for the arrest of haemorrhage and relief of dysphagia. Laser treatment has now entered the realms of routine clinical practice but its high cost and the operator expertise required suggest that its availability should be limited to designated centres.