内視鏡的 Nd:YAG レーザー治療とその問題点にっいて

Abstract

Endoscopic laser irradiation therapy was performed on 81 patients. The chief diseases of the patients were as follows; 20 cases of early gastric carcinoma, 7 cases of advanced gastric carcinoma, 5 cases of esophageal carcinoma and 24 cases of postoperative anastomotic stenosis. Most of these cancer patients were in old age, and had severe complications. In case of early gastric carcinoma, the prognosis of depressed type was worse than that of elevated one. About the size of the lesion, the most suitable case for laser therapy was that the area of the carcinoma in the mucous layer was less than 1cm in diameter. In most of these cases, carcinoma was disapeared after laser irradiation. On the other hand, in case that the area of carcinoma was more than 2cm in diameter, remaining of carcinoma was often recognized after laser therapy. In case of advanced gastric carcinoma, laser therapy for the stenosis of esophagocardiac junction was effective for oral food intakes. In case of postoperative anastomotic stenosis, laser therapy was very effective, particularly for relief of the stenosis of membranous one. In these cases, we usually use the contact type quartz fiber with cone shaped top end attachment. The fiber attachment of this type was called for cutting probe. In these cases, the combined use with the balloon dilator or bougie increase the improving effect for a long time.