Carbon dioxide laser bronchoscopy--a review of its use in the treatment of malignant tracheobronchial tumours in 142 patients.
We report our experience over an 8-yr period, 1984-1991, of the use of the carbon dioxide (CO2) laser in the treatment of otherwise inoperable malignant tracheobronchial lesions. In that period 142 patients (84 male, 58 female; median age 63 years) underwent 278 procedures. The trachea was the site of treatment in 44 patients, the carina in nine, a main bronchus in 80 and a lobar bronchus in nine. All resections were performed under general anaesthesia via a rigid bronchoscope. Symptomatic relief was obtained in 103 of the 116 patients whose main complaint was dyspnoea. Overall there was a mean improvement in forced expiratory volume in 1 s (FEV1) of 27%, in peak expiratory flow (PEF) of 22% and in forced vital capacity (FVC) of 7%. Most improvement in FEV1 and PEF was obtained by the treatment of tracheal lesions. Three patients died within 24 h of surgery and 30 day mortality was 18%. At a mean follow-up of 18.3 months the mean post-laser survival is 5 months. While the CO2 laser has limitations in the treatment of distal tumours when compared to the neodymium/yttrium aluminium garnet (Nd:YAG) laser, there was no higher incidence of complications. We have found CO2 laser bronchoscopy to be an effective palliation of inoperable malignant tumours particularly of the trachea and main bronchi.
Waller
D A
DA
Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle-upon-Tyne, U.K.
Gower
A
A
Kashyap
A P
AP
Conacher
I D
ID
Morritt
G N
GN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000503:physiopathology / Q000601:surgery*; D001999:Bronchoscopy; D002245:Carbon Dioxide; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D014134:Tracheal Neoplasms / Q000503:physiopathology / Q000601:surgery*
D002245:Carbon Dioxide