[Effect of endoscopic hydrothermo- and laser coagulation on the human stomach wall in vivo]

Effect of thermic and laser energy applied onto human in vivo gastric wall has not yet been reported in literature. In our study we evaluated the maximum amount of energy not harming the patient as well as principles for secure and sufficient therapy. In 8 patients hospitalized for gastric resection we applied vaporization by laser- and hydrothermosounds in this part of the stomach which should be resected. Endoscopic pictures were taken. We used a NdYAG laser (maximum performance 70 W, time of application 1-3 s) and hydrothermosounds (maximum performance 170 W, time of application 1-3 s). The stomach was resected 3-8 days following application. Comparing laser- and hydrothermosounds marks we observed a bigger area of necrosis at hydrothermosounds marks using the same amount of energy. In histological investigation correlation between depth and diameter of necrosis was found. After the same application time both depth and diameter of necrosis were bigger by hydrothermosounds than by laser. Lesions reached serosa at the maximum time of application of 3 s. Serosal lesion itself did not appear. Endoscopic treatment of tissue lesion by laser and thermic irradiation (vaporization of bleeding polyp pedicles, treatment of tumors) is secure using the maximum energy mentioned above. Serosal lesion did not appear. Bleeding lesions must be treated by higher energy because of absorption of energy by escaped blood.