Lasers in rectosigmoid tumors

Brunetaud, J. M.; Maunoury, V.; Cochelard, D.

doi:10.1002/ssu.2980110407

Cited by 26 publications

(10 citation statements)

References 18 publications

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“…Both argon and neodymium yttrium‐aluminium‐garnet (NdYAG) lasers have been used, although the latter is more common. In a series of 276 patients treated for advanced rectal cancer the immediate success rate was 85% [ 106]. Similar results have been described elsewhere [ 107–109].…”

Section: Local Methods Of Palliationsupporting

confidence: 63%

“…In particular it can be carried out above the peritoneal reflection and may be performed under mild sedation. Bleeding is rarely a problem and the overall morbidity of the procedure is of the order of 2–3% [ 106]. Similar to radiotherapy, patients often require further treatments, although this can usually be deferred by 6–8 weeks [ 110, 111].…”

Section: Local Methods Of Palliationmentioning

confidence: 99%

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Local methods of treatment of rectal cancer

Cook

Mortensen

2000

Colorectal Disease

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Over 11 000 new cases of rectal cancer are reported in the UK each year. Recent technical advances have increased interest in local management of the disease. The introduction of screening for colorectal cancer will potentially lead to an increased number of early rectal cancers suitable for local curative treatment. In addition, as the proportion of elderly patients in the population rises, local methods of treatment of rectal cancer will become increasingly important in this group of patients with comorbid disease. A literature search was performed on Medline database for English language publications on local treatments of rectal carcinoma. Preoperative assessment, selection of patients, local therapeutic and palliative methods of treatment were evaluated. Local methods of treatment can be used for potentially curative operations for rectal cancer. Preoperative endoanal ultrasound appears to be the most useful investigation for determining depth of local invasion. Transanal endoscopic microsurgery has extended the boundaries of local surgery and permits access to the mid and upper rectum with results similar to those of conventional local techniques. Laser therapy and transanal resection provide the best form of palliation for more advanced rectal carcinomas.

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Section: Local Methods Of Palliationsupporting

confidence: 63%

Section: Local Methods Of Palliationmentioning

confidence: 99%

Local methods of treatment of rectal cancer

Cook

Mortensen

2000

Colorectal Disease

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“…Endoscopic fulguration of benign colorectal adenoma with APC or LASER is becoming popular [1–3,5] and some believe it ought to be the treatment of choice [1]. Other forms of transanal treatment are transanal endoscopic microsurgery (TEMS) and local excisions [4,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…While intra‐abdominal, posterior and transanal approaches for surgical excision of rectal polyps have lower recurrence rates [4] endoscopic techniques allow unfit patients to be adequately treated and in others, to avoid more extensive procedures. However, with endoscopic techniques, there may not be enough specimen for complete histological study [5]. We have retrospectively reviewed our results in a group of patients with large rectal adenomas treated with LASER or APC.…”

Section: Introductionmentioning

confidence: 99%

Outcome of argon beam and LASER ablation of large rectal adenomas

2002

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OBJECTIVE: Endoscopic ablation of large rectal adenomas is being increasingly used as primary treatment. Despite the avoidance of general anaesthesia and the prevention of more major procedures, patients undergoing endoscopic ablation have the disadvantage of multiple treatment sessions and the lack of adequate tissue sample for complete histological study. The aim of this study was to analyse the outcome of all patients with large rectal polyps treated with endoscopic ablation. PATIENTS AND METHODS: Between 1993 and 1998, 29 patients who underwent endoscopic ablation of large rectal adenoma were identified. All their case notes were analysed and information was collected on recurrence, treatment episodes, complications, the incidence of carcinoma and the necessity for further procedures. RESULTS: At a median 40 (range 4-67) months follow-up, 41% of patients had recurrence of their adenoma and 14% had been diagnosed with adenocarcinoma. Only 24% of patients had been discharged while 21% were clear but were still under surveillance. Seven (24%) patients had complications, 6 stenosis and one severe bleeding. All stenosis occurred in patients who had more than 10 treatment sessions. In all, 31% of patients needed further endoanal or abdominal surgery and the median time to making this decision was 28 (range 4-66) months. There were no deaths. CONCLUSION: Laser and argon ablation of large rectal adenomas has proved very disappointing. It should be reserved for patients who are unfit to undergo general anaesthesia.

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“…Laser therapy has been shown to be appropriate for rectosigmoid cancers. In one study, there was an 85% success rate and a 2% complication rate in a series of 272 patients (51). In that series, patients had functional improvement for an average of 10.1 months.…”

Section: Nonsurgical Approachesmentioning

confidence: 99%