Endoscopic treatment with Nd: YAG laser and an indwelling silicon stent tube for cases with tracheobrnchial stenosis

Abstract

Endscopic Nd: YAG laser therapy is useful for the treatment of tracheobronchial stenosis. However, in case of restenosis of airway caused by a regrowth of tumor or granulation, and a fragility in respiratory tract with destroyed cartilagious rings, insertion of stent tube is frequently required. We treated six patients by using Dumon tube or T tube in comination with Nd: YAG laser therapy, in four cases with stenosis of trachea or main bronchus due to malignant disease, consisting of advanced lung carcinomas, tracheal carcinoma, and esophagus carcinoma invading to trachea, and in two cases with extensive post-tracheostomy stenosis. In all cases, symptoms of airway stenosis and pulumonary function were improved remarkably after the procedure, especially in two cases of post-tracheostomy stenosis indwelled Dumon tube or T tube were achieved a good quality of life for long term, and experienced no complications secondary to the stent placement. Although, in four cases of advanced malignant disease, three cases were died within two months after insertion of stent tube, except for one case of lung cancer eighteen months alive, a remarkable improvement of stenosis in respirstory tract was temporally obtained. Dumon tube and T tube were useful in alleviating symptoms of tracheobronchial stenosis, and effective for compressive stenosis of trachea and bronchus caused by tumor.