Endoscopic Laser Treatment for Gastrointestinal Vascular Ectasias

Forty-three patients with recurrent bleeding from gastrointestinal vascular ectasias had endoscopic treatment with either an argon or a neodymium-YAG (yttrium-aluminum-garnet) laser. Although 22 patients had some rebleeding, only 6 patients required resection for recurrent hemorrhage not controlled by laser treatments. Overall, the number of blood transfusions per patient decreased significantly (p less than 0.0001) when calculated for 6-month periods before and after initial laser treatments (1.5 +/- 0.2 U/month compared to 0.5 +/- 0.1 U/month). Rebleeding after the initial laser treatment was significantly more likely in patients with upper gastrointestinal ectasias than in patients with colonic lesions only (p less than 0.005).