Indication of Endoscopic Nd : YAG Laser Treatment for Tracheobronchial Cicatrical or Granulomatous Stenosis

Abstract

A total of 21 cases with cicatrical or granulomatous stenosis in the trachea or bronchus were treated with Nd : YAG laser endoscopically and the results obtained were as follows. 1) Overall effective rate of endoscopic Nd : YAG laser treatment was 90% at the period immediately after the treatment, however, it decreased to 67% or 57% at 2 to 3 months or 6 months after treatment. 2) Six of 7 cases with cuff stricture had stenosis again after Nd : YAG laser treatment, and tracheoplasty and silicone stent placement were performed in 3 relatively young cases and in 3 cases that were either elderly or had low pulmonary function, respectively. 3) The effect of endoscopic Nd : YAG laser treatment maintained the airway in cases with polypoid or intermediate type stenosis and in cases with circumferential type stenosis extending longitudinally for 10mm or less, suggesting that such cases are good indication for Nd : YAG laser treatment. 4) However, endoscopic Nd : YAG laser treatment resulted in failure in all cases with circumferential type stenosis extending longitudinally for 21mm or more, indicating the necessity of additional modalities including surgery or stents etc., combined with laser treatment.