Use of laser for rectal lesions in poor-risk patients

This study evaluates laser ablation of large polyps and cancer of the rectum in poor-risk surgical patients. We performed a retrospective review of treatment of rectal lesions with the neodymium yttrium aluminium garnet (Nd:YAG) laser. Biopsy was performed before the first and subsequent therapies....

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Bibliographic Details
Published in:The American journal of surgery 2004-12, Vol.188 (6), p.708-713
Main Authors: Kiran, Ravi P., Pokala, Naveen, Burgess, Phillip
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma - radiotherapy
Age
Aged
Aged, 80 and over
Anesthesia
Cancer therapies
Colon
Colonic Polyps - mortality
Colonic Polyps - pathology
Colonic Polyps - radiotherapy
Colorectal cancer
Diarrhea
Female
Follow-Up Studies
Histology
Humans
Laser
Lasers
Local therapy
Low-Level Light Therapy - methods
Male
Middle Aged
Neodymium
Neoplasm Staging
Ostomy
Pain
Palliation
Palliative Care - methods
Patients
Proctoscopy
Quality of Life
Radiation therapy
Rectal Neoplasms - mortality
Rectal Neoplasms - pathology
Rectal Neoplasms - radiotherapy
Rectum
Retrospective Studies
Risk Assessment
Survival Analysis
Treatment Outcome
Tumors
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Description
Summary:This study evaluates laser ablation of large polyps and cancer of the rectum in poor-risk surgical patients. We performed a retrospective review of treatment of rectal lesions with the neodymium yttrium aluminium garnet (Nd:YAG) laser. Biopsy was performed before the first and subsequent therapies. Large lesions were initially debulked by diathermy snare. Biopsies were performed on suspicious areas at follow-up after completion of therapy. Three patients with unresectable rectal cancer had symptom control over a mean period of 15.7 months and 12 patients with large polyps over 60.6 months since the start of therapy. Indications in polyps were carpeting of the rectum (n = 3), proximity to sphincter (n = 1), or comorbidity (n = 8). No complication occurred; however, there was 1 treatment failure. None of the patients with polyps developed cancer during a mean follow-up interval of 14 months after final treatment. Outpatient laser therapy is safe, repeatable, and effective in the local control of rectal lesions.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2004.08.043