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内腔镜激光治疗恶性食道梗阻渐为医务界广泛接受。采用Nd:YAG激光的标准方法,是Flescher首先所描述并用于治疗食管鳞状细胞癌,后来又用以治疗食管胃交界部的腺癌。治疗从肿瘤近端开始,每次可使1～2cm长的肿瘤组织汽化和凝固,间隔48小时后进行第二次治疗,完成治疗的次数取决于食管梗阻的长度。治疗较长的肿瘤会有穿孔的危险。作者提出了新的单次治疗法。先吞钡检查,确定肿瘤的位置、长度和梗阻程度,继以活检,查明组织学类型。在决定进行激光治疗后,再做内腔镜检查。将一特制的、顶端可以弯曲的不锈钢丝插入活检通道,在直视下轻
Endoscopic laser treatment of malignant esophageal obstruction is widely accepted by the medical community. The standard method using the Nd:YAG laser was first described by Flescher for the treatment of esophageal squamous cell carcinoma and later for the adenocarcinoma of the esophagogastric junction. The treatment started from the proximal end of the tumor and allowed the vaporization and coagulation of tumor tissue of 1 to 2 cm in length each time, and the second treatment was conducted after the interval of 48 hours. The number of completion of treatment depends on the length of esophageal obstruction. There is a danger of perforation when treating longer tumors. The author proposed a new single treatment. First swallow the examination to determine the tumor’s location, length and degree of obstruction, followed by biopsy to identify the histological type. After making a laser treatment, endoscopy was performed. Insert a specially made stainless steel wire with a bendable tip into the biopsy channel and light it under direct vision