Lasers in gastroenterology

Table 2 Comparison of modalities for palliation of malignant dysphagia

	Laser	Conventional stent	Self expanding metal stent
Technique	Basically safe (risk of perforation if dilatation also needed)	10% risk of perforation on insertion	Usually safe and easy to insert
Cost	High setup cost Low patient costs	Low cost	High cost
Contra	Fistula	High lesion	High lesion
indications	No endoscopic target	Tracheal compression	Tracheal compression Care with lesions crossing cardia
Dysphagia post	Variable, can be	Semi-solids	Variable, can be
therapy	close to normal	some solids	close to normal
Repeat Therapy	Possible. Usually required after 6-8 weeks	Stent can be adjusted	Difficult to adjust once inserted. Second stent or laser debulking for tumour overgrowth
Enhancement of	Yes	No	No
dysphagia relief with radiotherapy