Bown S G, Barr H, Matthewson K, Hawes R, Swain C P, Clark C G, Boulos P B
Br J Surg. 1986 Dec;73(12):949-52. doi: 10.1002/bjs.1800731203.
Seventeen patients with cancers of the rectum or distal sigmoid and considered inoperable because of old age, severe concomitant disease or advanced stage of malignancy, were treated endoscopically with the Nd YAG laser. Symptoms included rectal bleeding, obstruction, diarrhoea and incontinence. Significant improvement was achieved in 15 (88 per cent) and there were no complications. The procedure was carried out with simple bowel preparation and minimal sedation and, for otherwise fit individuals, the mean total hospital stay was 6.8 days, with day case therapy sometimes possible. Three patients required further therapy for recurrent symptoms 6-8 weeks after treatment. Fourteen patients died 1-39 weeks after therapy (mean survival 15 weeks). Three are alive and free of bowel symptoms after 39-54 weeks. This technique is the only non-surgical therapy that can be used safely for lesions above the peritoneal reflection and provides palliation at least as good as electrocoagulation, cryotherapy and radiotherapy with minimal upset to these seriously ill patients.
17例因年老、严重合并症或恶性肿瘤晚期而被认为无法手术的直肠或乙状结肠远端癌症患者，接受了Nd YAG激光内镜治疗。症状包括直肠出血、梗阻、腹泻和失禁。15例（88%）病情有显著改善，且无并发症。该手术只需简单的肠道准备和少量镇静剂，对于身体状况尚可的患者，平均总住院时间为6.8天，有时可进行日间治疗。3例患者在治疗后6 - 8周因症状复发需要进一步治疗。14例患者在治疗后1 - 39周死亡（平均生存期15周）。3例患者在39 - 54周后存活且无肠道症状。这项技术是唯一可安全用于腹膜反折以上病变的非手术治疗方法，其缓解症状的效果至少与电凝、冷冻疗法和放疗相当，且对这些重症患者的干扰最小。
