[Possibilities and limitations of laser therapy of the gastrointestinal tract]

Endoscopic laser therapy today is representing a promising branch in gastroenterology. Accepted indications are palliative recanalisation of tumor stenoses in the upper GI-tract and the rectosigmoidal part as well as bleeding GI-lesions. Reopening of tumor stenoses is possible in 90-95% of the cases with a low complication rate. Similar results are obtained with endocavital tumor destruction in the stomach and the rectum. Stop of GI-bleeding can be achieved equally effective by alternative methods like electrocoagulation and sclerotherapy. Only the tumor bleeding is better controlled by laser. Benign stenoses may be treated with laser as well, however conventional endoscopic techniques reveal similar results. Limits of laser therapy should be kept in mind. Uncritical use has to be avoided. Prior to laser therapy necessary diagnostic procedures have to be evaluated in order not to miss curative tumor surgery. An interdisciplinary approach including surgeons and radiologists is mandatory to obtain optimal results. Palliation today is the most important indication for laser therapy. Whether early cancer of the stomach will become an indication for curative treatment using photodynamic therapy remains to be seen in the future.