Use of neodymium yttrium aluminum garnet laser in long-term palliation of airway obstruction.
Palliation of acute airway obstruction using the neodymium yttrium aluminum garnet (Nd-YAG) laser was studied in 54 patients who presented over a 42-month period to the Yale cardiothoracic surgery service. Thirty-seven patients had bronchogenic carcinoma; 27 had stage IIIB or IV disease. Nine patients had endobronchial metastases from a primary nonbronchogenic carcinoma. Eight patients had benign disease. A total of 109 Nd-YAG laser tumor ablations were performed. In addition, 32 patients underwent postoperative brachytherapy. Median survival for all patients was 12 months. Patients with bronchogenic carcinoma had a median survival of five months. Fifteen of 20 patients (75%) alive at the time of follow-up reported continued palliation as shown by an improved postoperative Karnofsky score. There was no survival benefit from Nd-YAG laser ablation of endobronchial bronchogenic carcinoma; however, the Nd-YAG laser provided good to excellent palliation in the majority of patients on long-term follow-up.
Quin
J A
JA
Department of Surgery, Saint Mary's Hospital, Waterbury, USA.
Letsou
G V
GV
Tanoue
L T
LT
Matthay
R A
RA
Higgins
R S
RS
Baldwin
J C
JC
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D002283:Carcinoma, Bronchogenic / Q000150:complications / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D053685:Laser Therapy / Q000379:methods*; D008134:Long-Term Care; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome