Summary
Nd-YAG laser surgery via the fiberoptic bronchoscope can vaporize lesions causing
airway obstruction or stenosis located from the trachea to segmental bronchi with
minimized danger of bleeding, and improve ventilatory disturbances. 35 lesions in
the trachea and bronchus consisting of 27 malignant lesions and 8 benign lesions were
treated with endoscopic Nd-YAG laser surgery. The procedures were performed under
local anesthesia, and no significant side effects were recognized. The lesions was
irradiated with 20-80 W. power. In most cases a continuous wave was used, but in cases
of early stage squamous cell carcinoma intermittent irradiation of 0.5 second laser
spots were used. In 21 of 35 cases effective results were obtained. The non-effective
results obtained in 14 cases were considered to be due to inexact preprocedural evaluation
of the extent of the lesions. Effective results were obtained in 11 of 13 lesions
located in the trachea, in 3 of 5 lesions in the trachea and bronchus and in 7 of
17 lesions in the bronchus.
Tumor in the trachea with severe ventilatory disturbance is a good indication for
Nd-YAG laser surgery to rapidly alleviate symptoms. But in cases of lung cancer, indications
even as a palliative procedure are limited to those cases in which the lung parenchyma
distal to the stenotic portion is viable. However, the indications for this procedure
as a curative modality are extremely limited.
Key words:
Nd-YAG laser surgery - Airway obstruction
