Coppens J P, Desmarez B, Warzee P, Adler M, Van Wymersch T, Van Gossum A, Vanheuverzwyn R
Acta Gastroenterol Belg. 1988 Jul-Oct;51(4-5):407-11.
We report the results of endoscopic photocoagulation in the treatment of villous adenomas of the rectum in 49 consecutive patients (26 males, and 23 females, mean age: 74 years). Twenty-six patients were treated with a high-power Nd-Yag laser (80 W/sec). After a mean of 3.4 laser sessions, all the small-sized adenomas (C1) and 88% of the intermediate-sized adenomas (C2) were healed. No extensive villous adenoma (C3) could be eradicated. Complications occurred in 5 patients. Recurrence was observed in 3 C2 patients who are still on maintenance laser therapy. Twenty-three patients were treated with another Nd-Yag laser (maximal power output: 45 W/sec). After a mean of 6.4 laser sessions, 85% of the C1 patients were healed, while eradication of villous tissues was obtained in 60% of C2 and C3 patients. No complications were noted. A recurrence was observed in three C1 patients with secondary healing after reinstitution of laser therapy in 2 cases. Moreover, two C3 patients also relapsed and laser eradication was again obtained in 1 patient. In conclusion, these results confirm the efficacy of laser therapy in small- and intermediate-sized villous adenomas of the rectum. The number of laser sessions required for eradicating a villous tumour was lower using a high-power Nd: Yag laser, but the risk of complications was increased.
我们报告了对49例连续性直肠绒毛状腺瘤患者（26例男性，23例女性，平均年龄：74岁）进行内镜光凝治疗的结果。26例患者接受了高功率Nd-Yag激光（80瓦/秒）治疗。平均经过3.4次激光治疗后，所有小尺寸腺瘤（C1）和88%的中等尺寸腺瘤（C2）均愈合。没有广泛的绒毛状腺瘤（C3）能够被根除。5例患者出现并发症。3例C2患者出现复发，目前仍在接受维持性激光治疗。23例患者接受了另一台Nd-Yag激光（最大功率输出：45瓦/秒）治疗。平均经过6.4次激光治疗后，85%的C1患者愈合，60%的C2和C3患者的绒毛组织被根除。未观察到并发症。3例C1患者出现复发，2例在重新进行激光治疗后二次愈合。此外，2例C3患者也复发，1例患者再次通过激光根除。总之，这些结果证实了激光治疗对直肠小尺寸和中等尺寸绒毛状腺瘤的疗效。使用高功率Nd:Yag激光根除绒毛状肿瘤所需的激光治疗次数较少，但并发症风险增加。
