Use of laser for rectal lesions in poor-risk patients

Am J Surg. 2004 Dec;188(6):708-13. doi: 10.1016/j.amjsurg.2004.08.043.

Abstract

Background: This study evaluates laser ablation of large polyps and cancer of the rectum in poor-risk surgical patients.

Methods: 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.

Results: 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.

Conclusions: Outpatient laser therapy is safe, repeatable, and effective in the local control of rectal lesions.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy*
  • Aged
  • Aged, 80 and over
  • Colonic Polyps / mortality
  • Colonic Polyps / pathology
  • Colonic Polyps / radiotherapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Low-Level Light Therapy / methods*
  • Male
  • Middle Aged
  • Neodymium
  • Neoplasm Staging
  • Palliative Care / methods*
  • Proctoscopy
  • Quality of Life*
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / radiotherapy*
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome

Substances

  • Neodymium