RESUMEN
Two patients with gastric antral vascular ectasia--'watermelon stomach'--successfully treated with endoscopic Nd-YAG laser are described. This condition is an uncommon cause of iron deficiency anaemia due to chronic blood loss and is usually managed by antrectomy. Endoscopic therapy with Nd-YAG laser offers an effective and safe alternative to surgery particularly in the elderly poor-risk patient.
Asunto(s)
Gastroscopía , Fotocoagulación , Gastropatías/cirugía , Anciano , Vasos Sanguíneos/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antro Pilórico/irrigación sanguínea , Antro Pilórico/patología , Gastropatías/patologíaRESUMEN
Adenomatous polyps are the precursors of most colonic cancers and should be removed and recovered for histological analysis. Removal by endoscopic laser photocoagulation offers a safe alternative to surgery. We report our experience of managing selected colonic polyps by neodymium:yttrium aluminum garnet (Nd:YAG) laser.
Asunto(s)
Neoplasias del Colon/cirugía , Pólipos Intestinales/cirugía , Terapia por Láser , Neoplasias del Recto/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Endoscopic laser therapy with the neodymium-yttrium-aluminium-garnet (Nd-YAG) laser has been shown to provide good palliation of upper gastrointestinal obstruction caused by malignancy, and to be associated with a low morbidity and a low mortality rate. Fifty patients with inoperable upper gastrointestinal malignancy have been treated with this method: 22 had oesophageal carcinoma, 16 adenocarcinoma at the cardio-oesophageal junction, two carcinoma of the antrum and 10 recurrent tumours at the site of previous anastomoses. The main symptoms were dysphagia in 40 and vomiting in seven; three others had recurrent bleeding. An Nd-YAG laser was used to photocoagulate the tumours using power levels of 50-100 W and an average energy output per treatment of 10,000 J. Thirty patients (75%) with dysphagia improved with treatment but vomiting was relieved in only three of the seven patients with this symptom. Complications were infrequent--two patients (4%) developed a perforation and one had a respiratory arrest which was reversible. The 30-day mortality rate was 14% with 2% being related to the procedure. Endoscopic Nd-YAG laser therapy is an acceptable alternative to the more established methods of palliation such as surgical or endoscopic intubation.