Abstract: LITT has been used for the treatment of benign and malignant tumors since 1983. In all cases the laser fiber/s have been arranged at or near the center of the lesion and the duration of treatment, or fiber tip type, modified in an attempt to destroy the whole tumor. During the last 8 years the author has treated 344 symptomatic patients with more than 1,400 benign uterine leiomyomas by LITT. The first 50 cases were treated traditionally with the fibers directed towards the center of the tumor. Six cases subsequently required second stage LITT and four failed and required hysterectomy. The remaining patients were either treated by directing the laser fibers towards the periphery, where feasible, or throughout the tumor in parallel 3 cm apart. The latter achieved columns of coagulated tissue 5 mm in diameter an strips of healthy tissue between, which subsequently died from tissue anoxia because blood vessels had been coagulated. Research showed that any remaining tissue was deprived of enzymes, hormone receptors and epidermal growth factor and, therefore, did not grow. It is concluded that with malignant tumors cure rather than palliation might be achieved if the laser fibers were directed towards the periphery where the blood vessels enter, and that the surrounding healthy tissue be sacrificed for about 1 cm to destroy micro-invaded tissue and tumor cells within lymphatics.!18
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