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Clinical studies of endoscopic treatment for gastric cancer by neodymium yag laser



Clinical studies of endoscopic treatment for gastric cancer by neodymium yag laser



Journal of Tokyo Women's Medical College 57(5): 329-346



Endoscopic Nd-YAG Laser irradiation has been performed on 34 patients with gastric cancer, and the effectiveness of Laser treatment was studied. 17 cases out of them were irradiated with Nd-YAG Laser 1 to 25 days before surgical operation, and then we tried to inquire histo-pathological Laser effect for gastric cancer from the resected specimens. As a result, the cases which the cancerous infiltration confined within mucosa and submucosal tissue, could be effectively and radically treated by Laser. But it was suggested that the complete Laser treatment for the gastric cancer invaded expansively in the submucosal layer might be difficult. On the other hand, 17 cases with gastric cancer (contained 15 cases of early gastric cancer) on which surgery could be carried out by some reasons such as serious complications, were treated only by Laser irradiation, and followed up endoscopically (the longest period: 2 years and 8 months). Eight cases of protruded types of the early gastric cancer were successfully treated except 1 case of local recurrence. However, the result of treatment for depressed type of the early gastric cancer was poor. In 3 lesions of 2 cases, recurrence was proved by biopsy at the earlier stage after Laser irradiation. In another case, the biopsy specimen had showed carcinoma cells continuously in existence. From these point of view, Laser treatment is extremely suitable for protruded mucosal gastric carcinoma. Therefore, it is necessary to diagnose correctly the extention and depth of cancerous invasion before Laser treatment. Further it is important to know the existence of the lymph node metastasis for radical treatment, but it seems to be one of the crucial problems solved in the near future.

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Accession: 004972306

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