Endoscopic Nd:YAG laser therapy for active esophageal variceal bleeding. A randomized controlled study

Gastrointest Endosc. 1985 Feb;31(1):4-9. doi: 10.1016/s0016-5107(85)71954-2.


A randomized controlled double-blind study was undertaken to assess the efficacy and safety of endoscopic neodymium:yttrium aluminum garnet (Nd:YAG) laser therapy for active esophageal variceal bleeding. Ten patients were randomized to the laser treatment group and 10 to a control group that received sham endoscopy and standard medical therapy. Initial hemostasis was achieved in seven laser-treated patients but in 0 of 10 controls receiving sham treatment (p less than 0.002). However, four of the seven who were initially controlled with laser therapy had rebleeding 12 to 48 hours later; thus, three of 10 laser patients had lasting hemostasis. The mean blood transfusion requirements were similar in both groups (laser = 7.3 units; control = 7.8 units). Six of the 10 laser-treated patients were discharged from the hospital and four died. There were seven hospital deaths in the control group and three patients were discharged (p = 0.22). In two patients in the treatment group, laser therapy increased bleeding. There were no perforations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Esophageal and Gastric Varices / complications*
  • Esophagoscopy
  • Evaluation Studies as Topic
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Laser Therapy*
  • Male
  • Middle Aged
  • Random Allocation