レーザーブロンコスコープの臨床応用

抄録

Two cases of tracheal stenosis were successfully treated with the use of a specially designed laser bronchoscope.
Case 1. A 32-year-old male.
The patient met with a traffic accident in October, 1978. Tracheotomy was performed for lung complication. The tracheostoma was closed two months after the operation.
In April, 1980, he was admitted to our hospital as an emergency patient because of severe dyspnea. Cicatricial stenosis of the trachea was observed at the distance of 3cm from the carina. The inside diameter was only 3mm at the stenosis. No traditional procedures were thought to be useful to obtain a good air way. Therefore, we vaporized the cicatricious tissue with the use of the laser bronchoscope.
After the vaporization, the lumen of the stenotic area became 6.5cm in diameter, resulting in a normalrange of respiratory function. He has been free from the symtome for 6 months since the operation.
Case 2. An 84-year-old female.
The patient was a case of recurrent papillary adenocarcinoma of the thyroid gland. She first developed a mass of the thyroid gland in 1957. She had a hemithyroidectomy in 1969. Since then, she had had local recurrence twice and neck metastasis twice, each being surgically treated. In 1980, a recurrent tumor was developed from the anterior wall of the trachea. It occupied a half of the lumen. The tumor was located 3cm below the vocal folds extending 1.3 cm downward.
Because of the advanced age and the very slow proliferation of the tumor vaporization of the intra-tracheal mass was performed under the laser broncho-scope as a palliative treatment. Since the operation, she has been free from recurrence for 6 months.
On the bases of the clinical experiences described above, we can conclude that laser vaporization under the specially designed bronchoscope is the choice of treatment for some stenotic lesion of the trachea.