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Laser resection technique and results of multiple lung metastasectomies using a new 1,318 nm Nd:YAG laser system
Axel Rolle1, Arpad Pereszlenyi, Rainer Koch
1Department of Thoracic and Vascular Surgery, Centre of Pneumology and Thoracic Surgery, Coswig Specialised Hospital, D-01640 Coswig/Dresden, Germany. dr.rolle@fachkrankenhaus-coswig.de
Background And Objectives:
Advantages of a new 1,318 nm Nd:YAG laser based on multiple lung metastasectomies are shown.
Study Design/Materials And Methods:
Ninety-three percent of 328 patients with metastases (8/patient, range 1-124) had precision laser resections (lobectomy-rate reduced to 7%); this laser delivers 20 kW/cm(2) 1,318 nm power densities with 400 microm fibers, and a focussing handpiece. Absorption in water is tenfold higher.
Results And Conclusions:
Between 1/1996 and 12/2003 in 328 patients (164 males/females, 61 years) 3,267 nodules were removed. Pathologic examination revealed 2,546 metastases (range 3-80 mm) from kidney (n = 112), colorectal (n = 91), and breast cancers (n = 35). In 85% of patients where the complete resection was achieved the 5-year survival was 41%. For remaining 15% (incomplete resection) the 5-year survival was 7%. Five-year survival for patients with 10 (and more) metastases was 28%, for patients with 20 (and more) was 26%. No 30-day mortality was observed.
Conclusion:
This new laser system facilitates any kind of parenchymal lung resection in lobe-sparing manner and in case of complete resection improves significantly the survival.
