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Endoscopic neodymium yag laser therapy of tracheobronchial lesions



Endoscopic neodymium yag laser therapy of tracheobronchial lesions



Nippon Acta Radiologica 48(9): 1153-1166



After performing preliminary animal experiments, we made clinical use of Nd-YAG laser in 26 patients with tracheobronchial lesions during the period from October 1982 to June 1987. Nine patients with newly diagnosed primary lung cancer were initially treated with Nd-YAG laser which attempted to vaporize the intraluminal tumor. Five patients had a greater than 50 percent reduction of the intraluminal volume of tumor. Although all these nine patients received conventional radiotherapy with or without chemotherapy after the laser treatment, only two patients showed satisfactory improvement and survived. These two, still alive now with no recurrence, were the patients who had central type early lung cancer among those nine. Thirteen patients with recurrent lung cancer or metastatic cancer from other organs, who had received radiotherapy, chemotherapy or surgery previously, were treated with Nd-YAG laser for palliative relief from central airway obstruction or stenosis. Eight patients obtained succssful reestablishment of airway patency, and six of whom obtained immediate clinical improvement. The remaining two patients did not improve clinically; one due to lymphangitis carcinomatosa opf the lung and the other presumably due to chronic obstruction lung disease. Two patients with tracheal granuloma were treated easily withoutany hemorrhage and one patient with recurrent hemoptysis obtained immediate and lasting hemostasis with the laser treatment. Two fatal complications occurred among the overall group of 26 patients. One died of bronchopneumonia 7 day after the laser treatment, and the other died of acute respiratory failure within 12 hiours of laser treatment. There was no serious hemorrhage or perforation encountered in our cases. Laser therapy is extremely beneficial for the palliation in terminally ill patients with obstructing lesions of airway and also useful for the removal of granuloma and for hemostasis. Furthermore, laser therapy combined with radiotherapy may be curative in central type early lung cancer.

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Accession: 007300435

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