[Endoscopic resection in bronchology using the YAG laser. Evaluation of a 5-year experience]

The authors describe their experience with 1222 tracheobronchial endoscopic laser resections. The technique uses the thermal effects of the YAG laser which can be set to produce coagulation and vaporization. In most cases, the rigid bronchoscope under general anesthesia was preferred to the flexible fiberscope under local anesthesia. The main reason for this preference is that the rigid system allows management of hemorrhage should it occur. The technique is described with special attention to prevention of hypoxia, the major hazard. Inoperable malignant tumors accounted for 50% of the procedures. The other indications were tumors with uncertain prognosis, benign tumors, tracheal stenosis, and miscellaneous lesions. Results depend greatly on location. No fatality was recorded during the procedure, but two deaths did occur in the 48 hours thereafter. The authors conclude that endoscopic laser resection is a very effective modality for obstructive lesions in the main airways. It can be repeated as many times as needed and may be associated with other forms of therapy.