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Laser photoablation of colorectal adenomas: A 12-year experience

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Abstract

Background:

We analyze laser photoablation as an alternative treatment of large sessile polyps in inoperable patients.

Methods:

Ninety-four colorectal polyps (mean diameter 3.09 ± 2.7 cm, range 1–15 cm) were treated using high-energy lasers (Nd:YAG and diode). Grade of dysplasia was low in 51, high in 35, with focally invasive cancer in eight.

Results:

After 405 laser sessions (4.3 per polyp) five procedure-related complications were observed: two strictures, two bleedings, and one perforation. The last needed a surgical resection; the others were successfully treated by endoscopic therapy. Fifty-seven polyps (61%) were completely eradicated and the growth was controlled in all but two (98%). No degeneration was found after 28-month follow-up of treated adenomas with low- or high-grade dysplasia. Outcome of treatment was dependent on the dimension and grade of the dysplasia (p < 0.05), but not on the polyps’ position (rectum or colon). Relief of rectal bleeding was obtained in 90%, of mucus discharge in 77%, and of tenesmus in 100% of cases.

Conclusions:

Laser photoablation of colonic adenomas can be considered a valid procedure not only to relieve symptoms, but also to control the risk of degeneration in patients unfit for surgery or when surgical treatment is considered excessively invalidating.

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Authors and Affiliations

  1. Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Clinica Chirurgica Generale I, Università di Padova, Via Giustiniani 2, 35128 , Padova, Italy

    L. Norberto, L. Polese, I. Angriman, F. Erroi & D. F. D’Amico

  2. Istituto di Anatomia Patologica, Università di Padova, Via Giustiniani 2, 35128, Padova, Italy

    A. Cecchetto

Authors
  1. L. Norberto
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  2. L. Polese
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  3. I. Angriman
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  4. F. Erroi
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  5. A. Cecchetto
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  6. D. F. D’Amico
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Correspondence to L. Norberto.

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Norberto, L., Polese, L., Angriman, I. et al. Laser photoablation of colorectal adenomas: A 12-year experience. Surg Endosc 19, 1045–1048 (2005). https://doi.org/10.1007/s00464-004-2179-2

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  • DOI: https://doi.org/10.1007/s00464-004-2179-2

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