The use of endoscopic ultrasound and laser photocoagulation in the treatment of gastrointestinal tract tumours: early experience.
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Biomedical subjects
Publications and source records attributed to A C Steger.
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The palliative treatment of inoperable cancers of the oesophagus, gastric fundus and rectum can be difficult and unsuccessful. Laser beam irradiation therapy offers good palliation in the majority of patients but requires several treatment sessions to achieve this. We describe a small series of patients treated with a new direct contact low power laser technique using artificial sapphire probes. After one treatment, in patients with malignant dysphagia, two thirds could swallow solids and in patients with rectal cancers bleeding was stopped or reduced and diarrhoea stopped. The interval before a second treatment was needed was three and a half weeks. We feel this technique is a useful adjuvant to conventional laser therapy of inoperable gastrointestinal tract tumours, especially in providing effective palliation in one treatment session.
Proximal gastric vagotomy (PGV) consists of denervation of the body and fundus of the stomach, the antral nerve supply being left intact. It has a low operative morbidity and mortality and there are few postvagotomy side effects. However, the recurrent ulcer rate may be higher than with other operations for duodenal ulcer. Nevertheless it is usually easier to treat post-PGV recurrence than the complications of other gastric acid lowering operations. This study defines those patients in whom we have not performed a PGV. Of 110 operations for duodenal ulcer since 1980, 70 were PGVs while 40 consisted of truncal or selective vagotomy combined either with a drainage procedure or antrectomy. It is our practice not to perform a PGV in those patients with prepyloric ulcers, pyloric stenosis, bleeding or perforated ulcers and recurrent ulcers.
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