Prospective comparison of contact with noncontact Nd:Yag laser therapy for palliation of esophageal carcinoma.

Twenty patients with dysphagia due to inoperable esophageal cancer were randomized to receive either contact or noncontact endoscopic laser treatment. Treatment groups were similar with respect to age, dysphagia score, and tumor dimensions. The median number of initial treatment sessions was two in both groups, and the median treatment times per session were 23 min (range, 12 to 55 min) in the contact group and 19 min (range, 5 to 28 min) in the noncontact group. Median dysphagia scores were also similar in both groups 1 month after laser treatment, and no difference was apparent in the duration of palliation. There were no patient complications attributable to laser therapy, but damage to the laser wave guide occurred in three contact sessions and two noncontact sessions. These data suggest no advantage for the contact method of endoscopic Nd:YAG laser palliation of esophageal carcinoma with respect to number of treatment sessions, relief of dysphagia, or occurrence of complications.