[The application of laser therapy plus endobronchial stenting in treatment of complete airway obstruction].
OBJECTIVE
To assess the efficacy of laser therapy plus endobronchial stenting in the treatment of complete airway obstruction.


METHODS
17 cases with complete airway obstruction were treated with Nd: YAG laser and endobronchial stenting from April 1998 to November 2000. The patients' dyspnea, airway gauge, pulmonary function and complications were observed.


RESULTS
The airways were all restructured following a single or multiple laser treatment; the airway gauge enlarged and the average diameter increased (5.82 +/- 1.01) mm. Immediate relief of dyspnea was achieved in sixteen patients and dyspnea index lessened one grade in 4 patients, 2 grades in 11 and 3 grades in one. Obvious improvement of forced expiratory volume in one second (FEV(1)) was noted in all patients;the improvement averaged (0.49 +/- 0.18) L. Endobronchial stents were placed for 14 patients after laser treatment. After stent placement, the airway was further opened and the average airway gauge increased (3.50 +/- 0.94) mm further in diameter. Patients' dyspnea and FEV(1) were further improved; dyspnea index lowered one grade in eight patients and 2 grades in two patients. FEV(1) improved further (0.41 +/- 0.20) L in average. Complications after laser therapy included hypoxemia in 15 patients, hemorrhage in 2 and postoperative dyspnea in 3. Follow-up duration ranged from 2-20 months. Complications after stenting included recurrent pneumonia in 4 patients, airway obstruction due to granuloma or tumour growth in 5 and stent migration in 1.


CONCLUSIONS
Laser therapy and endobronchial stent placement were effective in the treatment of patients with totally occluded airway. Nd: YAG laser can be first chosen to restructure the occluded airway, then endobronchial stent must be used to further enlarge the airway and maintain the therapeutic effect.
Guo
J
J
Department of Respiratory Medicine, Guangdong Provincial People's Hospital, Guangzhou 510080, China.
Chen
Z
Z
Gao
X
X
Wang
S
S
Li
J
J
Zhang
W
W
Li
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000601:surgery / Q000628:therapy*; D002404:Catheterization; D002648:Child; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007440:Intubation; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015607:Stents