High energy laser irradiation and electric surgery for obstructive gastrointestinal cancer

A total of 35 patients with advanced obstructive gastrointestinal cancer received monopolar electrosurgery and Nd: YAG laser therapy from January 1985 to June 1988. These included 13 cases of esophageal cancer (U/3 6, M/3 2, L/3 5), 14 case of gastric cancer (cardia 7, corpus 3, antrum 4), and 8 cases of rectal cancer. Twenty (esophageal 9, stomach 8, rectal 3) of 35 patients had much improved results, with the size of the lesion reduced over 90%, and the endoscope could smoothly pass through the stenotic area after electrosurgery or laser therapy. The other 12 patients had partially improved results with the tumor size being reduced 50-90% and the patients could take semiliquid food easily. Both groups of much improved or partial improved had a statistically significant difference (P less than 0.01) compared to the group of failures to treatment. Two patients developed bleeding after treatment. Twenty-one patients died of causes other than complications of electrosurgery or laser therapy. The average survival was 6.8 months. Nd: YAG laser and electrosurgery can provide good palliative results and contribute to a good quality of life in advanced obstructive gastrointestinal cancer.