title: Endobronchial therapy with a thulium fiber laser (1940 nm).
abstract: BACKGROUND
  Nd:YAG laser (1064 nm) is standard in bronchology. The thulium fiber laser (1940 nm) has a nearly 1000-fold increased absorption in water, enabling precise tissue ablation with a small margin of coagulation, whereas 1064-nm laser light penetrates deeper into tissue with less controllable effects.
  
  
  OBJECTIVE
  To assess the safety, feasibility, and versatility of endobronchial thulium laser therapy in an observational cohort study.
  
  
  METHODS
  Endobronchial treatment with the thulium fiber laser was performed in a cohort study of 187 bronchoscopies on 132 consecutive patients with 135 endobronchial lesions amenable to laser resection.
  
  
  RESULTS
  The thulium fiber laser produced superficial, precise, and rapid tissue ablation. Eighty-one lesions were completely vaporized; 82 lesions were treated by deep tissue destruction by inserting the fiber into tissue followed by mechanical resection. Tumor bleeding was coagulated with rapid and sustained hemostasis (n = 28). Nitinol stents were removed after resection of severe granulation tissue overgrowth (n = 10). Intact stents were maintained after ablation of in-stent tissue (n = 47). In 11 cases, bleeding occurred during laser treatment (n = 11 of 187). Power settings between 5 and 20 W were found to be safe.
  
  
  CONCLUSIONS
  Endobronchial therapy with the thulium laser at 1940 nm seems to be safe, feasible, and highly versatile for treatment of airway stenosis and stent obstruction caused by tissue ingrowth. Further studies are warranted.
authors: Department of Pneumology, Asklepios-Fachkliniken Munich-Gauting, Comprehensive Pneumology Center Munich, Gauting, Germany. Electronic address: w.gesierich@asklepios.com.
authors: Wolfgang
authors: W
authors: Gesierich
authors: Department of Pneumology, Asklepios-Fachkliniken Munich-Gauting, Comprehensive Pneumology Center Munich, Gauting, Germany.
authors: Frank
authors: F
authors: Reichenberger
authors: Krankenhaus Martha-Maria, Muenchen, Germany.
authors: Andreas
authors: A
authors: Fertl
authors: Department of Pneumology, Asklepios-Fachkliniken Munich-Gauting, Comprehensive Pneumology Center Munich, Gauting, Germany.
authors: Karl
authors: K
authors: Haeussinger
authors: Laser-Forschungslabor, Hospital of University of Munich, Muenchen, Germany.
authors: Ronald
authors: R
authors: Sroka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000175:diagnosis / Q000601:surgery*; D001982:Bronchial Diseases / Q000175:diagnosis / Q000601:surgery*; D001999:Bronchoscopy; D003251:Constriction, Pathologic; D020878:Device Removal; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054023:Lasers, Semiconductor / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D015607:Stents; D013932:Thulium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013932:Thulium