«Endoscopic laser therapy in complex treatment of ulcers of stomach and duodenum»

In medicinal endoscopy we widely use endoscopic laser therapy - directly on an ulcerative defect of stomach and duodenum. During medicinal process a serial helium-neon laser ютк-1 with wave length 0.65 m and maximum output power 25 mW was used. To apply laser radiation to a pathologic focus a monolight guide with diameter 2.5 mm and length 2.5 m, which was laid through biopsy channel of a fiber-optic gastroduodenoscope made by the firm «Olympas» (Japan), was used.

Before a course of treatment during endoscopic examination 95 patients at the age of 25 up to 62 were found to have both acute and chronic ulcers of stomach and duodenum of different localization, without signs of a beginning cicatrisation. Local treatment of stomach ulcers was carried out only after histological confirmation of a benign nature of ulcers. Ulcer dimensions varied from 0.7 cm up to 2.5 cm.

The distal end of an endoscope was brought to an ulcerative defect under direct vision, and then there was an exposure of laser beam precisely on an ulcer during 2-4 min. depending on the ulcer dimensions and its endoscopic characteristic. Course of endoscopic laser therapy averaged 10 seances.

The experience of application of laser therapy directly on an ulcer has shown its considerable efficiency: first 1-3 seances rendered analgetic effect even in case of the apparent pain syndromes; good anti-edematous action was observed; during the subsequent seances of laser therapy ulcer was cleaning from deposit-detritus and then there was an accelerated maturation and growth of granulation tissue followed by quick ulcer epithelization and recovery of mucin-producing function of integumentary epithelium. It is necessary to note that at healing of ulcers of stomach and duodenum under radiation exposure scars are elastic and they do not create rough cicatricial deformity of a pylorus and bulb of duodenum (in case of duodenum ulcers).

At analysis of the follow-ups four patients, for which repeated courses of endoscopic laser therapy were carried out with good therapeutic effect, have been found to have recurrence of stomach ulcer.

/«Materials of the Scientific-Practice Conference of Endoscopists of Ukraine», 1996, Kiev/