Naveau S, Poitrine A, Poynard T, Thuvignon E, Chaput J C
Gastroenterol Clin Biol. 1984 Jun-Jul;8(6-7):545-50.
The aim of this study was to report results of endoscopic YAG laser therapy in palliative treatment of esophageal and cardial carcinoma. Twenty-eight patients were treated: 9 with adenocarcinoma and 19 with squamous cell carcinoma. Among these patients, 9 had complete aphagia; radiotherapy was contraindicated in 17; in the remaining 2 patients the aim of laser therapy was to achieve sufficient luminal enlargement to allow the endoscopic insertion of a prothesis. Dysphagia improved in 24 cases; destruction of a major portion of the intraluminal tumor was achieved in 17 patients, and incomplete destruction was possible in 9 patients. In one case, the treatment had no effect. Among 22 subjects in maintenance treatment, 13 good results were obtained. Several complications of laser therapy were observed: 2 cases of minor bleeding, 2 cases of esophagitis and 1 perforation of the upper esophagus. The patient died after surgical operation. It is concluded that endoscopic YAG laser therapy for palliative treatment of esophageal and cardial carcinoma is effective, providing rapid improvement of dysphagia. Maintenance treatment is necessary to sustain the improvement. Randomized studies are now needed to compare endoscopic laser therapy with other palliative treatment of malignant tumors of the upper gastrointestinal tract.
本研究旨在报告内镜下YAG激光疗法对食管癌和贲门癌进行姑息治疗的结果。共治疗28例患者：9例为腺癌，19例为鳞状细胞癌。这些患者中，9例完全吞咽困难；17例放疗禁忌；其余2例患者激光治疗的目的是使管腔充分扩大以便内镜下置入假体。24例患者吞咽困难得到改善；17例患者实现了腔内肿瘤大部分的破坏，9例患者可能破坏不完全。1例患者治疗无效。在22例维持治疗的患者中，13例取得了良好效果。观察到激光治疗的几种并发症：2例轻微出血、2例食管炎和1例食管上段穿孔。该患者术后死亡。结论是内镜下YAG激光疗法对食管癌和贲门癌进行姑息治疗是有效的，能迅速改善吞咽困难。维持治疗对于维持改善效果是必要的。现在需要进行随机研究，以比较内镜激光疗法与上消化道恶性肿瘤的其他姑息治疗方法。
