YAG laser endoscopic treatment of an esophageal and sigmoid stricture after end-to-end anastomosis stapling

Abstract

Endoscopic laser photocoagulation has many advantages over electrocautery. It avoids direct contact with tissue, controls the thermal reaction, and obviates current flow through the tissue. New applications are being devised in the treatment of gastrointestinal tract disorders.1,2 In addition to laser coagulation for the treatment of bleeding gastrointestinal lesions, we used laser endoscopy for the treatment of gastrointestinal tract strictures caused by the end-toend anastomosis (EEA) auto-suture stapling procedure in two cases. power output of 100 watts and a sigmoidofiberscope (Olympus CF-1TS2) was done. Conditions of the irradiation were power output, 80 watts; irradiational pulses, 1.0 sec; and total energy, 2507 joules. The lesion was vaporized from the inner side with laser applied at locations of 12, 6, 3, and 9 o'clock. Follow-up sigmoidoscopy 1 week later showed a wider orifice (1.5 em in diameter) (Fig. IB). Closure of the T-colostomy was done in January 1983. Barium enema at that time showed a smooth passage (Fig. 2), and bowel movements were normal during 4 months' follow-up.