Nd-YAG laser, a new palliative alternative in the management of esophageal cancer.

Ten patients with unresectable esophageal malignant tumor have been managed by Nd-YAG laser palliative therapy. Esophageal obstruction, and dysphagia, the most frequent symptoms, were relieved in all cases after periods ranging from 5 to 14 days. The mean total energy required was 26.121 watts sec-1. No serious immediate or late complication was encountered, except for one small transient bleeding without clinical repercussion. Two relapses of dysphagia were successfully managed by the same procedure. This new palliative approach has to be compared with the other available methods, surgical resection and bypass procedures, radiotherapy or endoscopic prosthetic intubation. Its high degree of effectiveness in providing rapid relief of dysphagia, and its low morbidity rate will give to laser therapy an important place in the future palliative management of esophageal cancer, either alone or in combination with other treatments.