Endoscopic ND:YAG laser treatment of rectosigmoidal cancer

Over a period of 7 years 126 patients with rectosigmoid carcinoma considered unsuitable for surgery underwent endoscopic Nd:YAG laser treatment for palliation of symptoms and tumor eradication, if feasible. Altogether 72 (59%) of the lesions had distal margins less than 7 cm from the anus and 32 (23%) above the peritoneal reflection. In 14 patients with tumor less than 3 cm in diameter, symptomatic improvement was achieved in all. In the remaining 112 patients with larger tumors (81 greater than 3/4 circumferential, mean length 5.5 cm) symptomatic improvement was achieved with repeated treatments (average 3.7) in 58 (71%). All treatment failures occurred in patients with extensive tumors (17 initial, 12 late). Bowel perforation did not occur and there was no treatment related mortality. The average stay in hospital for all laser patients was 9 days (32% of patients were outpatient attendance). These results suggest that laser therapy may be the palliative treatment of choice in patients with rectosigmoid carcinoma unsuitable for surgery.