Endobronchial Nd:YAG laser surgery

Thirty-six malignant and four benign endotracheal and endobronchial lesions were treated using Nd:YAG laser through flexible bronchoscope from November 1985 to July 1987 at the University Hospital in Louisville, Kentucky. Progressive dyspnea and hemoptysis were primary indications for the procedures. The majority of patients were treated under general anesthesia using intravenous agents. Most patients required two treatment sessions for complete endobronchial tumor ablation. The mean hospital stay was 48 hours. Two patients died postoperatively; one died of myocardial infarction and another of progressive respiratory failure. The mean survival was 13 weeks. Sixty-three percent of patients treated were improved as measured by Karnofsky Performance Status. Mean change in Performance Status between pre- and post-laser treatment was 100% (from 30 to 60). We conclude that therapeutic laser bronchoscopy is a useful adjunctive treatment in selected patients with obstructing or bleeding lung tumors.