Abstract
Nd-YAG laser irradiation via the fiberoptic bronchoscope was performed in cases of tracheobronchial lesions to widen the airway in cases of stenosis of major airways by benign or malignant tumors, vaporization of small malignant lesions in inoperable cases or to coagulate bleeding lesions.
During 2 years and 7 months, 36 malignant and 14 benign cases were treated. To improve techniques of laser treatment, we studied effects on survival in malignant cases or the pathological effects on benign lesions.
Because of the nature of the malignant case, i.e. advanced cancer cases with severe dyspnea in which are confronted with a catastrophie outcome, it is impossible to make a comparison in terms of 6 month survival. However, it can be said that this modality can obtain relief and improvement in the quality of life in these cases and render theircancidates for other palliative modalities such as chemotherapy or radiotherapy. Nevertheless, it must be realized that this mode of treatment does not alter the natural history and systemic program of the disease.
In other words it appeares that this method has no effect on factors affecting survival apart from the episode of respiratory distress.
In benign cases in which active inflammation is not present, a single vaporization procedure is generally sufficient, but cases of active inflammation showed regrowth to the original conditions within one week to 3 months.
In conclusion, despite the ever increasing enthusiasm for laser applications in medicine, in cases involving the tracheabronchial tree, this particular method is indicated in only a small number of cases.
It is essential to comprehend the principle and effects of this method when selecting candidates, but in those few cases in which it is indicated it can be dramatically effective in relieving the symptoms of respiratory distress.
