Use of laser for rectal lesions in poor-risk patients.
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.
Kiran
Ravi P
RP
Department of Surgery, Great Western Hospital, Swindon, Wiltshire, United Kingdom. madhurkiran@hotmail.com
Pokala
Naveen
N
Burgess
Phillip
P
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009354:Neodymium; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D011351:Proctoscopy; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D009354:Neodymium