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Ann Thorac Surg 1984;38:374-381
© 1984 The Society of Thoracic Surgeons


Articles

One Hundred Neodymium–YAG Laser Ablations of Obstructing Tracheal Neoplasms

Grant V.S. Parr, M.D.*, Michael Unger, M.D., Robert G. Trout, M.D., William G. Atkinson, M.D.

Pulmonary and Thoracic Surgery Sections, Presbyterian–University of Pennsylvania Medical Center, Philadelphia, PA

* Address reprint requests to Dr. Parr, Medical Office Bldg Suite 105, Presbyterian–University of Pennsylvania Medical Center, 39th and Market Sts, Philadelphia, PA 19104

Forty patients with obstructing, nonresectable tracheal neoplasms underwent 100 ablations with the neodymium–yttrium-aluminum garnet (YAG) laser. The laser allows bloodless resection and vaporization of tumors. Unlike the carbon dioxide laser, the neodymium–YAG laser can be used with the flexible bronchoscope and has an excellent effect on coagulation.

Thirty-four patients had primary lung malignancies (epidermoid in 24); 4 had metastatic malignancies; and 2 had benign lesions. Results have been excellent in 22, fair in 10, and poor in 8. No patient has died or had a deleterious result. Complications have occurred in only 1 of 89 ablations done with the flexible bronchoscope.

We believe that the neodymium–YAG laser is effective in opening major tracheal or bronchial obstructions and offers substantial symptomatic improvement in patients who are short of breath. Although this treatment is only palliative, the results have been excellent in more than half of the patients.




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