Author/Editor		Pernat, Cvetka; Pocajt, Milan
Title		Vloga laserja v paliativnem zdravljenju raka požiralnika
Translated title		The role of laser therapy in the palliative treatment of esophageal cancer
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 68, št. 7-8
Publication year		1999
Volume		str. 413-4
Language		slo
Abstract		Background. Esophageal cancer represents one of most difficult gastrointestinal neoplasms to manage. In extensive disease, when patients are inoperable, pallinative treatment must provide adequate swollowing. The aim of our study was to evaluate the role of laser in pallative treatment of esophageal cancer. Patients and methods. Between January 1993 and September 1998 62 patients with advanced malignant obstruction of the esophagus were treated by Nd-Yag laser. The indication for laser therapy was dysphagia. Patients were from 37 to 90 yr old with an average age of 56. There were 49 males and 13 females. Cancers were classified in the cervical esophagus, if the tumor began less than 15 cm from incisors, middle if 23-30 cm and distal if more than 30 cm. Most cancers were distal. The number of laser treatments performed varied from 1 to 9 per patient, with average of 3.5. Results. Palliation was achived in 88%: 43 patients were able to eat nearly normal diet, 12 patients were able to swollow fluids and semisolids. Best results were obtained on medial and distal thirds of the esophagus. There were two serious but nonfatal complications, one esophagobroncial fistula and one episode of bleeding, directly attributate to Nd-Yag laser therapy. Conclusions. Endoscopic laser therapy is an effective method in palliation of esophageal cancer with low risk of complications.
Summary		Izhodišča. Rak požiralnika predstavlja eno izmed najtežje dosegljivih neoplazem za zdravljenje. V poznem stadiju bolezni, ko tumor povzroči zaporo požiralnika, je smiselno palativno zdravljenje. Namen naše študije je bil oceniti vlogo laserja v palativnem zdravljenju raka požiralnika. Bolniki in metode. Od januarja 1993 do septembra 1998 smo z laserjem zdravili 62 bolnikov z maligno obstrukcijo požiralnika. Uporabljamo Nd-Yag laser. Indikacija za zdravljenje je bila disfagija. Bolniki so bili stari od 37-90 let, povprečna starost je bila 56 let. 49 je bilo moških in 13 žensk. Rak smo razdelili glede na lokalizacijo na zgornjega, če je bil tumor do globine 15 cm od zgornjega roba, srednjega v globini 23-30 cm in spodnjega v globini nad 30 cm od zgornjega roba. Opravili smo 1-9 laserskih posegov, povprečno 3,5. Rezultati. Rekanalizacijo smo dosegli v 88%: 43 bolnikov je lahko uživalo solidno hrano, 12 tekočo in sesekljano hrano. Zdravljenje je bilo uspešnejše v srednjem in spodnjem požiralniku. Opazovali smo 2 resna zapleta laserskih posegov: ezofagobronhialno fistulo in obilnejšo krvavitev, ki smo jo zaustavili z laserjem. Zaključki. Endoskopsko lasersko zdravljenje je varno in učinkovito za paliativno rekanalizacijjo maligne obstrukcije požiralnika.
Descriptors		ESOPHAGEAL NEOPLASMS ENDOSCOPY, DIGESTIVE SYSTEM LASER SURGERY TREATMENT OUTCOME SLOVENIA PALLIATIVE CARE