Literature DB >> 29452076

Feasibility of EUS-guided Nd:YAG laser ablation of unresectable pancreatic adenocarcinoma.

Francesco Maria Di Matteo1, Paola Saccomandi2, Margareth Martino1, Monica Pandolfi1, Margherita Pizzicannella1, Valerio Balassone1, Emiliano Schena3, Claudio Maurizio Pacella4, Sergio Silvestri3, Guido Costamagna5.   

Abstract

BACKGROUND AND AIMS: EUS has become an interventional technique in which a needle may be used as a vehicle to deliver therapeutic agents. Laser ablation (LA) has been used to treat many primary and secondary neoplasms. This study aimed to assess the feasibility of EUS-guided LA for unresectable (UR) pancreatic cancer.
METHODS: Patients with stage IIb-III pancreatic cancer underwent EUS-guided LA. All patients were unresponsive to previous chemoradiotherapy. LA was performed by using a 300-μm flexible fiber preloaded onto a 22-gauge fine needle. A 1064-nm wavelength neodymium-yttrium aluminum garnet (Nd:YAG) laser light with different power settings of 2 W for 800 J, 1000 J, and 1200 J; 3 W for 800 J, 1000 J, and 1200 J; and 4 W for 800 J, 1000 J, and 1200 J was used. Each patient was treated with a single application of 1 of these settings. The application time of the power settings ranged from 200 to 600 seconds.
RESULTS: Nine patients (median age, 74.7; range 55-85) underwent Nd:Yag LA. The mean size of the focal lesion was 35.4 mm (range, 21-45). The ablation area, demonstrated by 24-hour CT, ranged from .4 cm3 (for the lower power setting of 2 W/800 J) to a maximum of 6.4 cm3 (for 4 W/1000 J). The procedure was completed in all 9 patients without adverse events.
CONCLUSION: In our human experience, EUS-guided LA was feasible and well tolerated in patients with UR pancreatic cancer.
Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Year:  2018        PMID: 29452076     DOI: 10.1016/j.gie.2018.02.007

Source DB:  PubMed          Journal:  Gastrointest Endosc        ISSN: 0016-5107            Impact factor:   9.427


  11 in total

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2.  Endoscopic Ultrasound-Guided Laser Ablation Using a Diffusing Applicator for Locally Advanced Pancreatic Cancer Treatment.

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Review 4.  Therapeutic EUS: New tools, new devices, new applications.

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Journal:  Endosc Ultrasound       Date:  2019 Nov-Dec       Impact factor: 5.628

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Review 9.  Endoscopic ultrasound role in pancreatic adenocarcinoma treatment: A review focusing on technical success, safety and efficacy.

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Journal:  World J Gastroenterol       Date:  2022-01-21       Impact factor: 5.742

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