Palliative laser treatment of rectal cancer

Endoscopic neodymium-yttrium aluminum garnet laser treatment is a therapeutic modality for gastrointestinal neoplasms.

Patients given palliative therapy with laser for invasive rectal cancer during 1989-93 at the Dept. of Surgery, University of Turku, were analyzed.

All 20 patients (median age, 81.5 years) were unsuitable for radical surgery owing to the poor clinical condition and/or advanced disease. In 14 (70%) patients laparotomy and diversion was avoided with laser treatment; 6 patients underwent laparotomy, 2 for pelvic infiltration and large-bowel obstruction, 2 for rectovaginal fistula formation, and 1 for severe pain. One patient underwent abdominoperineal resection for bleeding after laser treatment. Postoperative complications developed in three (15%) patients--two episodes of bleeding and one of sepsis; none of these complications was fatal.

Local palliative laser treatment of rectal carcinoma is efficient in patients who are unsuitable for radical surgery. Operative diversion can be avoided without deaths and with minimal morbidity.