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Published on: May 9, 2018
Use of laser for rectal lesions in poor-risk patients
Ravi P Kiran1, Naveen Pokala, Phillip Burgess
1Department of Surgery, Great Western Hospital, Swindon, Wiltshire, United Kingdom. madhurkiran@hotmail.com
Background:
This study evaluates laser ablation of large polyps and cancer of the rectum in poor-risk surgical patients.
Methods:
We performed a retrospective review of treatment of rectal lesions with the neodymium yttrium aluminium garnet (Nd:YAG) laser. Biopsy was performed before the first and subsequent therapies. Large lesions were initially debulked by diathermy snare. Biopsies were performed on suspicious areas at follow-up after completion of therapy.
Results:
Three patients with unresectable rectal cancer had symptom control over a mean period of 15.7 months and 12 patients with large polyps over 60.6 months since the start of therapy. Indications in polyps were carpeting of the rectum (n = 3), proximity to sphincter (n = 1), or comorbidity (n = 8). No complication occurred; however, there was 1 treatment failure. None of the patients with polyps developed cancer during a mean follow-up interval of 14 months after final treatment.
Conclusions:
Outpatient laser therapy is safe, repeatable, and effective in the local control of rectal lesions.
