Historically, the development and marketing of the neodymium-yttrium-aluminum-garnet (Nd:YAG) laser was associated with the insertion of markedly fewer conventional prostheses for the palliation of malignant dysphagia. Subsequently, the introduction of self-expandable metal stents (SEMS) has, in turn, led to a diminished role not only for laser therapy but also for other ablative modalities, including bipolar cautery, argon plasma coagulation (APC), and the injection of caustics. Two ablative modalities deserve ongoing consideration, but not because they have been proven to be better or more cost-effective than SEMS. These include photodynamic therapy (PDT), because of its potential to ablate large areas of low-grade malignancy, and injection of chemotherapeutic agents or T-lymphocytes sensitized to an individual malignancy. The latter, while theoretically promising, will require considerably more study before widespread clinical application.
References
Intestinal tract stenting. In: Classen M, Tytgat GNJ, Lightdale CJ (eds) Gastroenterological endoscopy. Stuttgart; Thieme 2002: 372-386
Esophageal endoscopy, dilation and intraesophageal prosthetic devices. In: Hill LZ, Kozarek RA, McCullum RW, Mercer DE (eds) The esophagus. Medical and surgical management. New York; WB Saunders 1988: 47-59
Injection therapy for esophageal carcinoma. In: Barken JS, O’Phelan CA (eds) Advanced therapeutic endoscopy. New York; Raven Press 1994: 41-44
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