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Clinical InvestigationsA Two-Year Experience with the Neodymium-YAG Laser in Endobronchial Obstruction
Section snippets
Methods
All patients were referred for endoscopic management and palliation of significant symptomatic airway obstruction due to a malignant or benign process. Our intent was to accept and attempt laser resection on all patients referred for palliation. On the basis of initial clinical experience, we expected to develop guidelines for patient selection and treatment technique. In each case, conventional treatment with surgery, radiation, and chemotherapy had failed or the patient was considered
Results
One hundred sixteen patients received 176 Nd:YAG laser treatments from March 25, 1982, through March 24, 1984. Patients ranged in age from six months to 84 years, and the median age was 60 years. The 78 male (67 percent) and 38 female (33 percent) patients in the treatment group had nine benign lesions and 107 malignant lesions. Seventy-one patients had bronchogenic carcinoma. Of the 71 carcinomas, 65 (91.6 percent) were stage III, 1 (1.4 percent) was stage II, and 5 (7.0 percent) were stage I.
Discussion
At the time we began using the Nd:YAG laser for endobronchial resection of end-stage malignant tumors, there were no established criteria for patient selection, laser power settings, anesthetic techniques, or bronchoscope selection. At first, we attempted to treat any patient referred to us with malignant airway obstruction in whom all other reasonable methods of treatment had failed. Our initial criteria, established after 22 cases, were that the tumor should be endobronchial, that it should
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Manuscript received June 9; revision accepted August 20.