Palliation of colorectal carcinoma with the Nd-YAG laser

The Nd-YAG laser used for endoscopic palliation of carcinoma of the rectum (n = 16) or the sigmoid colon (n = 5). Indications were cardiorespiratory insufficiency, advanced disease, severe concomitant illness or patient's refusal of surgery. The treatment was repeated every 2-3 (range 1-5) months, with about half the sessions on an out-patient basis. Symptomatic relief was excellent in 16 of 20 patients, moderate in three and poor in one case (1 patient was asymptomatic). The treatment was effective against bleeding, mucous discharge and signs of intestinal obstruction, but not against incontinence. In the absence of incontinence, palliation was excellent in patients with noncircumferential tumours and in four of the five with circumferential growth. In the latter group frequent treatment sessions were required for long tumours. There were no major complications. Endoscopic laser therapy is concluded to provide rapid, safe and excellent control of local symptoms in most patients with inoperable colorectal carcinoma, to be less useful when the tumour is large and circumferential and not effective in patients with incontinence.