| Abstract: | Neodymium-Yag laser treatment in 130 patients with upper gastrointestinal bleeding, including spurting arterial bleeding, active oozing or fresh stigmata of bleeding (fresh clot or non-bleeding vessel), permitted overall initial haemostasis in 95% of the patients. Total laser failures (rebleeds) amounted to 22%. Considering only the ulcers with vessels in 36 patients, initial control of haemorrhage was achieved in 83%, but the total failure rate amounted to 50%. A controlled randomized study in 129 patients with oozing bleeding and patients with stigmata of bleeding showed a significant (p less than 0.001) reduction of duration and of the recurrence rate of bleeding and a significant decrease (p less than 0.05) of operative indications. Mortality rates however were not lowered by laser therapy. Complications of lasertherapy did not occur. One hundred thirty-eight gastrointestinal angiomas were treated by Yag laser photocoagulation in 32 patients without complications. Although the results of Yag laser treatment of gastrointestinal bleeding seem promising, endoscopic laser techniques should be improved to optimise the results and to improve the prognosis of life-threatening gastrointestinal bleedings. |
