[Laser therapy of the lower gastrointestinal tract. A report of experiences]

In the years 1985 to 1988, 15 patients with advanced rectal or rectosigmoidal tumors causing stenosis or bleeding were submitted to palliative Neodymium-YAG laser therapy. In addition, twelve patients with remnant adenomas after endoscopic polypectomy and three patients with benign strictures were treated to attempt cure. Stenosis and bleeding could be effectively treated in all cases. Three patients developed unmanageable tumor recurrences and eventually had to undergo colostomy after a mean lag period of seven months (1.6 to 8.8 months). Mean survival time presently is 6.3 months. Of the tumor patients, five are still alive. Ten out of twelve remnant colorectal adenomas could be eradicated by additional laser treatment. There was one recurrence. Two patients did not attend to follow-ups. All three anastomotic strictures could be recanalized by laser treatment. Two of these three patients later developed recurrences, which could likewise be effectively managed by repeated laser application. There were no treatment-associated complications in these patients. Our results give additional confirmation, that ND-YAG lasers are effective for the palliative treatment of tumor stenoses and tumor bleeding of the rectal and rectosigmoidal area and also may be a valuable therapeutic modality for benign strictures and remnant adenomas in selected patients.