Endoscopic Nd-YAG laser therapy in upper gastrointestinal tract

Forty-seven patients with gastrointestinal bleeding, benign tumor and malignancy were treated by YAG-laser therapy from 1980 to 1987. For active bleeding, laser coagulation was effective in inducing hemostasis. This therapy was also effective for the potential bleeding lesions. Benign sessile lesions such as polyp and adenoma were completely treated by laser vaporization. In cases with malignancy, the small-sized early gastric cancer (less than 15 mm in diameter) could be effectively treated. Among them, one case was followed up for as long as 82 months without any sign of recurrence. On the other hand, poor results were obtained in the cases suffering from early esophageal cancer due to incomplete laser irradiation resulting from the fear of penetration through the thin-walled esophageal mucosa. However, for the malignant stricture, the laser therapy was useful to relieve the lesion due to the regression of the tumor size. After the treatment, the patient was able to take meals orally. The above data demonstrate that the laser therapy is useful for the treatment of bleeding, sessile lesions, small-sized early gastric cancers and malignant strictures induced by advanced cancer.