Nd:YAG laser treatment of colorectal villous tumors

Fifty-eight patients, 23 men, 35 women (mean age 76 +/- 10 yrs), with colorectal villous adenomas underwent endoscopic neodymium Yag laser therapy. In 50 patients with interpretable results, tumor ablation was complete in 45 p. 100 of extensive adenomas involving at least two thirds of the circumference and extending longitudinally for at least 4 cm, in 92 p. 100 of intermediate adenomas between 1 and 4 cm in diameter and in 100 p. 100 of small adenomas with diameter less than or equal to 1 cm. These patients had a mean follow up of 72 weeks (range 13-182 wks). Twelve adenomatous tissue recurrences occurred in 9 patients. In 10 of these recurrences, laser ablation was effective. Age, sex, dysplasia grade, macroscopic appearance, or tumor location did not influence the results which were related to the size of the villous adenomas. Four complications occurred: a symptomatic stenosis, an asymptomatic stenosis, an ileocaecal fistula and a rectal fistula near a colorectal anastomosis.