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Preoperative neodymium-YAG laser treatment of obstructive colon cancer.

Present conventional surgical therapy of obstructive colon cancers of the right colon is primary resection, whereas in the left colon it is a two-stage or three-stage operation with a temporary colostomy. Morbidity and mortality rates in staged operations are still as high as 40% and 24%, respectively. Preoperative recanalization of obstructive cancers by neodymium-YAG laser vaporization will tend to relieve the symptoms of ileus and will permit preoperative peroral bowel lavage. For this reason primary resection with primary anastomosis is practicable in patients who have recovered from symptoms of ileus. In 27 cases who had been operated on with left-side hemicolectomy or anterior resection, the mortality rate was 3.7% (1/27). The total inpatient mortality rate of all laser-treated patients who had been operated on by different operative procedures, or who had not been surgically treated, was 8.8% (5/57).