Therapeutic Laser Endoscopy in Gastrointestinal Disease

The endoscopic use of lasers in the treatment of gastrointestinal d~seases began within the last decade and has evolved rapidly. Work is now being done at more than 150 centers in Europe, the United States, Japan and the rest of the world. To date no publi­ cation has defined the state of the art. This text attempts to fill that void. To disseminate information about therapeutic laser endoscopy, an increasing number of short courses have been sponsored in the United States wherein the attendee hears didactic lectures, views video tapes, and in addition, has the opportunity to have a "hands-on" experience with endoscopic laser therapy in the animal labs. This book is an expansion of the material presented in one such course sponsored by The Cook County Hospital in Chicago, Illinois, in October, 1982. The course was organized by Peter Bright-Asare, M. D. , Chairman of Gastroenterology at the time of the course and chaired by Dr. Bright-Asare and myself. Some of the lectures from the course have been broadened and formalized. Other chapters were invited and added. Also included are group discussions about issues that are either controversial or undefined. Attempts were made to secure consensus opinion from experienced investigators in areas where no hard scientific experimental or clinical data exists. The contributors have a wide range of interest and expertise. Dr.

Inhalt

1. Medical laser fundamentals.- 2. Laser tissue interaction.- 3. Natural history of upper gastrointestinal bleeding and determinants of outcome.- 4. Endoscopic control of gastrointestinal bleeding with don-laser devices.- 5. Endoscopic and pharmacologic therapy of upper gastrointestinal bleeding. Laser vs. pharmacotherapy vs. autacid.- 6. European experience with Nd: YAG and argon laser for therapy of upper gastrointestinal bleeding.- 7. Controlled trials of laser therapy in the treatment of upper gastrointestinal haemorrhage.- 8a. Treatment techniques for massive upper gastrointestinal bleeding. General considerations.- 8b. Specific treatment techniques for massive upper gastrointestinal bleeding.- 9. Therapy of upper gastrointestinal bleeding: Electrocautery vs. argon laser vs. Nd: YAG laser. Panel discussion. Moderator.- 10. A general overview of treatment techniques. Panel discussion. Moderator.- 11. Endoscopic laser therapy of upper gastrointestinal carcinomas.- 12. Laser therapy of colonic neoplasms.- 13. Gastrointestinal angiomata: diagnosis and treatment with laser therapy and other endoscopic modalities.- 14. Non-gastrointestinal uses of lasers in medicine and surgery.- 15. Organization of a multidisciplinary laser center.- 16. Complications of endoscopic laser therapy.- 17. Use of lasers in community hospitals in United States.- 18. Legal aspects of laser use in the United States.- 19. Undecided issues about the use of lasers in gastrointestinal disease. Panel discussion. Moderator.- 20. Current limitations, new technological directions and areas of investigation. Panel discussion. Moderator.