Laser Photocoagulation of Esophageal Carcinoma to Relieve Dysphagia

Abstract

In the course of two studies 231 patients with carcinoma of the esophagus were treated with Nd:YAG laser photocoagulation of tumor tissue to relieve distressing dysphagia. Some of the patients' carcinoma was advanced, and some had severe dysphagia. There were 155 males and 76 females. In one study 85% of the patients were over 50 years old, and in the other 60% were between 50 and 70. The site of the tumor was upper one-third in 24 cases, middle one-third in 98 cases, and lower one-third in 109 cases. Squamous cell carcinoma accounted for 193 cases. In 21 patients there was more than one tumor site. In 144 cases the tumor was more than 4 cm in length. Esophageal lumen was restored in all cases but was poorly sustained in 19 cases. Further sessions of laser treatment were needed in all of these cases. Patients received a mean of 2.7 sessions of laser therapy. All cases were subjected to dilation of the involved segment before laser therapy. Complications were seen in 20 cases but there were no deaths attributable to the laser procedure. Mean survival was 5.5 months (1–14 months in one study and 1–19 months in the other). Nd:YAG laser therapy for relief of dysphagia in carcinoma of the esophagus is quick, effective, and safe.