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Endoscopic Ablation of Esophageal Malignancies With the Neodymium-YAG Laser and Electrofulguration

Endoscopic Ablation of Esophageal Malignancies With the Neodymium-YAG Laser and Electrofulguration Abstract • The case reports of 40 patients with obstructive esophageal cancer treated with electrofulguration (EF) or neodymium (Nd)-YAG laser were reviewed. Surgery was contraindicated because of advanced carcinoma (17 patients), recurrence after resection (13 patients), recurrence after irradiation (four patients), and poor medical condition (four). Two patients refused surgery. There were 31 men and four women; mean age was 62 years. There were 31 adenocarcinomas, eight squamous cell carcinomas, and one metastatic breast carcinoma. Tumor locations were lower esophagus in 35 patients, middle esophagus in three, and cervical esophagus in two. Thirty-five patients had obstructions; two, bleeding, and three, both. None of the patients could swallow solids. A total of 255 treatments were given (mean, 6.6 per patient). The mean number of Nd-YAG treatments was 1.9; for EF, 1.3. All 40 patients tolerated solid food after treatment and the esophagus remained open from three to 14 weeks. Mean survival from first treatment was 11 months; from diagnosis, 17 months. Both techniques were safe and effective. (Arch Surg 1989;149:225-228) References 1. Ellis FH: Carcinoma of the esophagus . CA 1983;33:264-281. 2. Cukingnam RA, Carey JS: Carcinoma of the esophagus . Ann Thorac Surg 1978;26:274.Crossref 3. Gunnlangsson GH, Wychulis AR, Roland C, et al: Analysis of the records of 1657 patients with carcinoma of the esophagus and cardia of the stomach . Surg Gynecol Obstet 1970;130:997. 4. Cassidy DE, Nord HJ, Boyce HW Jr: Management of malignant esophageal strictures: Role of esophageal dilation and peroral prosthesis . Am J Gastroenterol 1981;76:173. 5. Fleischer D, Kessler F: Endoscopie Nd:YAG laser therapy for carcinoma of the esophagus: A new form of palliative treatment . Gastroenterology 1983;85:600-606. 6. Mellow MH, Pinkas H: Endoscopic therapy for esophageal carcinoma with Nd:YAG laser . Gastrointest Endose 1984;30:334-339.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Endoscopic Ablation of Esophageal Malignancies With the Neodymium-YAG Laser and Electrofulguration

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References (6)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410020099016
Publisher site
See Article on Publisher Site

Abstract

Abstract • The case reports of 40 patients with obstructive esophageal cancer treated with electrofulguration (EF) or neodymium (Nd)-YAG laser were reviewed. Surgery was contraindicated because of advanced carcinoma (17 patients), recurrence after resection (13 patients), recurrence after irradiation (four patients), and poor medical condition (four). Two patients refused surgery. There were 31 men and four women; mean age was 62 years. There were 31 adenocarcinomas, eight squamous cell carcinomas, and one metastatic breast carcinoma. Tumor locations were lower esophagus in 35 patients, middle esophagus in three, and cervical esophagus in two. Thirty-five patients had obstructions; two, bleeding, and three, both. None of the patients could swallow solids. A total of 255 treatments were given (mean, 6.6 per patient). The mean number of Nd-YAG treatments was 1.9; for EF, 1.3. All 40 patients tolerated solid food after treatment and the esophagus remained open from three to 14 weeks. Mean survival from first treatment was 11 months; from diagnosis, 17 months. Both techniques were safe and effective. (Arch Surg 1989;149:225-228) References 1. Ellis FH: Carcinoma of the esophagus . CA 1983;33:264-281. 2. Cukingnam RA, Carey JS: Carcinoma of the esophagus . Ann Thorac Surg 1978;26:274.Crossref 3. Gunnlangsson GH, Wychulis AR, Roland C, et al: Analysis of the records of 1657 patients with carcinoma of the esophagus and cardia of the stomach . Surg Gynecol Obstet 1970;130:997. 4. Cassidy DE, Nord HJ, Boyce HW Jr: Management of malignant esophageal strictures: Role of esophageal dilation and peroral prosthesis . Am J Gastroenterol 1981;76:173. 5. Fleischer D, Kessler F: Endoscopie Nd:YAG laser therapy for carcinoma of the esophagus: A new form of palliative treatment . Gastroenterology 1983;85:600-606. 6. Mellow MH, Pinkas H: Endoscopic therapy for esophageal carcinoma with Nd:YAG laser . Gastrointest Endose 1984;30:334-339.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1989

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