Abstract
Endoscopic laser treatment (ELT) has been proposed as one of the curative endoscopic
therapies for early gastric cancer. We report our experience with ELT in 111 patients
with early gastric cancer limited to the mucosa as diagnosed by endoscopy and/or endoscopic
ultrasonography. Twelve patients subsequently underwent laparotomy after ELT and no
residual tumor was found in 75 % of these cases. Ninety-nine patients had no surgery
for various reasons and follow-up information by endoscopy was available for 73 of
them for a mean of 2.7 years (range 1 to 7 years). 81 % of these patients were found
to be tumor free. There was no difference in the success rate of ELT in relation to
endoscopic classification, tumor location and histologic type of cancer. Recently,
the indications for ELT decreased due to the development of endoscopic mucosal resection
(EMR) enabling histological evaluation of a resection specimen. However, the technique
of EMR cannot always be performed completely depending on the location and size of
the lesions. Therefore, we employed ELT as an additional treatment technique after
EMR therapy to achieve complete tumor destruction. Results in 13 patients where both
techniques were employed showed complete tumor removal in 11 cases. At present, this
combined application may be the most important role of laser irradiation for the treatment
of early stage GI tract malignancies.
