Endoscopic Nd-YAG laser treatment of colorectal neoplasms. A four-year longitudinal study

In order to gain a longitudinal perspective of the benefits, complications, and role of the neodymium yttrium aluminum garnet (Nd-YAG) laser in the treatment of colorectal neoplasms, we performed a review of endoscopies using the laser during a 53-month period ending in January 1989. We reviewed the records of 100 patients for details of the endoscopic procedure and demographic data. Performance status and survival were critically assessed. We performed 275 procedures on 57 men and 43 women with an average age of 76.5 years. An average of 2.75 procedures, each lasting an average of 45 minutes, were performed per patient. Half of the patients had fulgurations of rectal tumors with the common indication being bleeding. Thirteen morbid events and no deaths occurred. Ninety-six per cent of the procedures were performed with the patient under intravenous sedation. The Karnofsky performance scale applied to surviving patients revealed that 90 per cent were able to care for themselves and scored greater than 70. Average survival was 5.58 months. Our results indicate that the Nd-YAG is a safe and effective tool in the treatment of colorectal neoplasms offering palliation as well as maintenance of quality of life.