[Dilatation of anastomotic stricture by Nd:YAG laser beam under endoscopy].

ABSTRACT

Anastomotic stricture has become a common complication following surgical treatment of upper gastrointestinal cancers. A technique was devised to alleviate the stricture with Nd. YAG laser beam under endoscopy. The laser beam was applied at 3-4 different points near the anastomotic stoma. The thermal effect of the beam would cut the scar tissues in and underneath the mucosa, leading to dilatation of the stoma. A total of 48 patients with cancer of the esophagus (n = 21), gastric cardia (n = 20), body of stomach (n = 6) and gastric stump (n = 1) with postoperative anastomotic stricture was so treated. According to the degree of dilatation, the result of treatment upon longterm follow-up was good (the anastomotic stoma was enlarged more than 6 mm) in 41 (85.4%), fair (the stoma enlarged 4-5 mm) in 5 (10.4%) and poor in the remaining 2. Due precautions should be made to avoid bleeding and perforation.