Oesophageal carcinoma: laser palliation in 231 cases.
Two hundred and thirty-one patients of advanced oesophageal carcinoma were treated with Neodymium: Yttrium-Aluminium-Garnet (Nd:YAG) laser photocoagulation of tumour tissue to relieve distressing dysphagia. There were 155 males (67.1%) and 76 females (32.9%). The mean age was 59.6 years. Eighty-five percent (196 cases) were above 50 years of age. Distribution of tumour by site was as follows: upper one-third--24 cases (10.4%), mid one-third--98 cases (42.4%) and lower one-third--109 cases (47.1%). Squamous cell carcinomas accounted for 83.5% (193) of cases. Nearly two-thirds (144 cases, 62.3%) were more than 4 cm in length. Tumour deposits were found at more than one site in 11 cases (4.7%). Oesophageal lumen was restored in all cases but was poorly sustained in 19 cases (8.2%). Further sessions of laser therapy were required in all these cases. A mean of 2.7 sessions of laser treatment was required to achieve adequate lumen. One hundred and eighty-nine patients (82%) had good relief of dysphagia to liquids and semi solids. Complications were seen in 20 cases (8.6%). There were no deaths related to the procedure. Mean survival was 5.5 months (1-14 months). Nd:YAG laser therapy offers effective palliation of dysphagia in carcinoma of the oesophagus with acceptable morbidity and no mortality.
Rau
B K
BK
Department of Surgery and Endoscopy, Willingdon Hospital, Madras, India.
Harikrishnan
K M
KM
Krishna
S
S
D000230:Adenocarcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003680:Deglutition Disorders / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010166:Palliative Care