Chest
Clinical InvestigationsNd:YAG Laser Bronchoscopy: A Five-Year Experience with 1,396 Applications in 1,000 Patients
Section snippets
Materials and Methods
Almost all the patients treated had significant symptoms of airway obstruction due to a malignant or benign process. In some patients with lesions such as benign endoluminal tumors, selected carcinoids, early cancers, tracheobronchial granulomas, etc, laser therapy was performed for cure. In most instances, however, the laser was used as a palliative therapy for patients with endoluminal tracheobronchial lesions in whom conventional therapy had failed or had not been considered possible or
Results
From April 1982 to July 1987, 1,000 patients were treated with the YAG laser for a total of 1,396 procedures performed by the first author only. The number of treatments per year increased constantly: 64 in 1982, 205 in 1983, 256 in 1984, 308 in 1985, and 342 in 1986.
There were 772 tracheobronchial tumors, 139 nonmalignant tracheal stenoses and 89 miscellaneous conditions (Table 1).
Technique
Two different methods of laser application in bronchology have been developed: via the rigid or the fiberoptic bronchoscope. In general, the flexible method is opted for by bronchoscopists who have little or no experience with the rigid bronchoscope.
The preference for the rigid bronchoscope by authors with the largest series of cases8 and by ourselves is essentially for safety reasons: using the wide operating channel, the patient can be ventilated, blood and secretions aspirated, and laser
Addendum
A total of 1,751 treatments in 1,261 patients has now been performed. This additional experience has not modified our judgment on procedure.
ACKNOWLEDGMENT
We are grateful to Doctors F. Beamis and Stanley M. Shapshay for their helpful suggestions, thoughtful assistance and revision of the English text.
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Manuscript received November 16; revision accepted January 4.