Endobronchial laser therapy--differential therapeutic use and clinical value

Endobronchial laser irradiation was performed on 27 patients with inoperable malignant (n = 23) and benign (n = 4) disease of the bronchial system for the treatment of recurrent pulmonary bleeding and recanalization of centrally obstructed or stenosed airways. The essentially palliative measure led in more than half the patients with hemoptysis to immediate and lasting hemostasis, in all patients with stenosis to complete or partial restoration of airway patency, and in 7 of 11 patients with total obstruction to a radiologically verifiable re-expansion of atelectasis. In the total of 58 laser treatments performed, complications occurred in three cases and were managed by conventional clinical measures. Successful recanalization in patients with pre-existing bronchial obstruction presupposes a short-segment, polypous tumor growth, intact bronchial wall structures, and short occlusion time. In addition to the treatment and prophylaxis of recurrent pulmonary bleeding, the principal use of endobronchial laser treatment in the future will probably concentrate on the palliative therapy of preocclusive stenoses of the trachea and main bronchi.