ABSTRACT
The two major applications for endoscopic laser therapy (ELT) in the upper gastrointestinal (UGI) tract are for the treatment of bleeding and for neoplastic disease. Acute hemorrhage and lesions that have bled but are not actively bleeding have been treated. Benign and malignant tumors of the pharynx, esophagus, stomach, duodenum, and ampulla of Vater have been lased. For neoplasms, the treatment is generally palliative to ameliorate symptoms and to improve the quality of life. Curative therapy has been accomplished on rare occasions in the United States, but it is uncommon. In Japan, where the diagnosis of early gastric cancer is more commonly made, there is a growing experience with curative treatment by laser. In China, where esophageal cancers may be detected earlier, there has been some application of the laser for curative therapy. In addition to the laser's utility for bleeding and neoplastic diseases of the UGI tract, it has also been used endoscopically to treat some benign strictures of the esophagus secondary to reflux, postanastomotic benign strictures, esophageal and duodenal webs and rings, and to drain pseudocysts of the pancreas (Table 1).
