The laser: an alternative for palliative treatment of obstructing intraluminal lesions

Twenty nine patients with carcinoma obstructing the colon, six obstructing the gastroesophageal junction, six obstructing the tracheobronchial tree, and one patient with recurrent transitional cell cancer of the bladder invading the rectum, not amenable to surgical resection, were treated by laser photocoagulation. Forty were treated with the Nd:YAG laser and two with the CO2 laser. There were 26 men and 16 women with an average age of 73.8 years. The locations of the tumors were 17 rectal, six rectosigmoid, one transverse colon, two descending colon, four ascending colon, six gastroesophageal, and six in the tracheobronchial tree. Symptoms consisted of obstruction and/or bleeding. Seventeen patients were poor surgical candidates, 25 were unresectable due to widespread disease, two had recurrence at the anastomosis, and three patients had another primary site not controlled by their previous surgical procedure. There were seven complications--three perforations, a rectovaginal fistula, two failures in therapy, and lower GI bleeding. Nineteen patients have died of their disease. Tumors were eradicated in two patients. Forty patients had remained free of referring symptoms of obstruction and bleeding.