title: Endoscopic Nd:YAG laser therapy for villous adenomas of the right colon.
abstract: BACKGROUND
  Endoscopic laser therapy is considered an acceptable treatment of benign colorectal adenomas. The aim of our study was to evaluate the efficacy of Nd:YAG laser to ablate right-sided colonic sessile adenomas.
  
  
  METHODS
  Between January 1990 and February 1996, 56 patients underwent laser therapy because of high operative risk or refusal of surgery. Lesions were located as follows: cecum (23), ascending, (15), and hepatic flexure (18). Six patients (10.7%) had multiple polyps in the ascending colon. Histologic examination showed a tubulovillous pattern in 20 (35.7%) and a villous pattern in 36 (64.3%). Low-grade dysplasia was detected in 44 patients (78. 5%) and high-grade dysplasia in 12 (21.4%).
  
  
  RESULTS
  The number of laser sessions ranged between 1 and 6 (median 3) and complete ablation, histologically confirmed, was achieved in 49 cases (87.5%). Seven patients (12.5%) underwent surgery: 2 for incomplete tumor destruction, 3 because of invasive carcinoma on repeated biopsies. Two patients (3.6%) had complications (one perforation of the cecum and one hemorrhage). Follow-up ranged from 6 to 60 months and no recurrences were observed.
  
  
  CONCLUSIONS
  Laser therapy is an effective method for the destruction of sessile adenomas of the right colon in selected patients.
authors: Department of Gastroenterology, National Institute for Cancer Research, National Institute for Cancer Research, Genoa, Italy.
authors: M
authors: M
authors: Conio
authors: F X
authors: FX
authors: Caroli-Bosc
authors: R
authors: R
authors: Filiberti
authors: R
authors: R
authors: Dumas
authors: P
authors: P
authors: Rouquier
authors: J F
authors: JF
authors: Demarquay
authors: H
authors: H
authors: Aste
authors: S
authors: S
authors: Marchi
authors: J P
authors: JP
authors: Delmont
mesh_terms: D018253:Adenoma, Villous / Q000601:surgery*; D000368:Aged; D002430:Cecal Neoplasms / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D013997:Time Factors