Rantala A, Ovaska J
Dept. of Surgery, University of Turku, Finland.
Scand J Gastroenterol. 1995 Feb;30(2):177-9. doi: 10.3109/00365529509093258.
Endoscopic neodymium-yttrium aluminum garnet laser treatment is a therapeutic modality for gastrointestinal neoplasms.
Patients given palliative therapy with laser for invasive rectal cancer during 1989-93 at the Dept. of Surgery, University of Turku, were analyzed.
All 20 patients (median age, 81.5 years) were unsuitable for radical surgery owing to the poor clinical condition and/or advanced disease. In 14 (70%) patients laparotomy and diversion was avoided with laser treatment; 6 patients underwent laparotomy, 2 for pelvic infiltration and large-bowel obstruction, 2 for rectovaginal fistula formation, and 1 for severe pain. One patient underwent abdominoperineal resection for bleeding after laser treatment. Postoperative complications developed in three (15%) patients--two episodes of bleeding and one of sepsis; none of these complications was fatal.
Local palliative laser treatment of rectal carcinoma is efficient in patients who are unsuitable for radical surgery. Operative diversion can be avoided without deaths and with minimal morbidity.
内镜下钕钇铝石榴石激光治疗是胃肠道肿瘤的一种治疗方式。
对1989年至1993年期间在图尔库大学外科接受姑息性激光治疗浸润性直肠癌的患者进行分析。
所有20例患者（中位年龄81.5岁）因临床状况差和/或疾病晚期而不适合进行根治性手术。14例（70%）患者通过激光治疗避免了剖腹手术和改道；6例患者接受了剖腹手术，2例因盆腔浸润和大肠梗阻，2例因直肠阴道瘘形成，1例因剧痛。1例患者在激光治疗后因出血接受了腹会阴联合切除术。3例（15%）患者出现术后并发症——2例出血和1例败血症；这些并发症均无致命性。
对于不适合进行根治性手术的患者，局部姑息性激光治疗直肠癌是有效的。可以避免手术改道，无死亡病例，发病率最低。
