Summary
Eighteen patients with malignant inoperable stenoses of the upper digestive tract were treated with a combination of laser (neodymium-YAG) coagulation and bougienage. Following treatment, 14 out of 18 patients (78 %) were able to eat solid food again; the width of the lumen was greater than 11 mm in every case. Between 1 and 5 laser sessions (median 3.5) and between 1 and 2 (median 1) bougienages were required; per session, between 1,017 and 9,096 joules (median 3,362) were required, and a total of between 4,770 and 36,244 joules (median 8,763) were utilized per patient treated.
To date, 6 patients remain free of dysphagia (at between 3 and 24 weeks), 1 patient has in the meantime been submitted to surgery. In 7 patients, recurrent stenosis occurred, which was again treated with the laser (3) or with an endoscopically implanted prosthetic tube (4). In 4 patients, the result was unsatisfactory. By way of major complications, merely one perforation occurred.
We conclude that the combined use of laser coagulation and bougienage represents an effective and largely complication-free palliative treatment for malignant stenoses in the upper digestive tract.
Key words:
Oesophageal stenosis - Neodymium YAG laser - Bougienage - LBT
