Nd-YAG laser as a palliative treatment for malignant dysphagia

Two hundred and twenty-four patients with histologically-confirmed carcinoma of the oesophagus received palliative Nd-YAG laser therapy for malignant dysphagia between January 1986 and December 1994. The results are appraised in terms of the degree of relief obtained, its relation to the macroscopic type and the size of the tumour, peri-operative complications, duration of hospitalization and survival after treatment. Recannulation of the oesophageal lumen was obtained in 98.2% of the patients, after which 93.7% were able to ingest at least semi-solids. Although the lumen was permeable for a 9.8 mm endoscope, the remainder could only ingest liquids. The only complication was a perforation is six cases (2.7%). After treatment, 14.8% survived more than 1 year and 3.4% more than 2 years. After discussing the role of lasers in the palliative treatment of malignant dysphagia, the authors conclude that it can be considered effective in that it relieves the dysphagia and improves the patients' quality of life.