PALLIATIVE TREATMENT OF ESOPHAGUS TUMORS WITH LASER (ND-YAG) - RESULTS OF AN INITIAL EXPERIENCE

Palliative treatment of Esophagus tumors a to a remarkable improvement of dysphagia allowing oral feeding, prolonging the survival period an d improving patient's Quality of Life. We have treated 30 patients wit h such tumors, who had previously been discarded for surgical therapy, with Nd-YAG Laser through endoscopy. The procedure could be ended, so the dysphagia improved remarkably, in 23 patients (77,7%). Survival m ean length was 7,3 months (range: 2,5-22 months) in eleven patients wh o already died when this study was finished, and 6,5 months (range: 2, 5-10 months) in the remaining 12 patients. Five patients required the implant of a esophagic prothesis as result of a proneness of the tumor to produce stenosis again. Follow up visits were done regularly every 1 to 1,5 months. In summary best results were obtained on medial and distal thirds of the esophagus, where dilatation previous to laserther apy is easier, obtaining an important improvement of dysphagia. If the tumor has a localization in the upper part of the esophagus or if it has its origin in the stomach and later on it invades cardias, both ca ses pose more difficulties to the treatment with laser, which determin es the results, so another alternative technique to feed the patient m ay be used.