Nakano M, Fukuda M, Sasayama K, Nakata T, Fujimoto S, Araki J
Department of Internal Medicine, Nagasaki City Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Jun;30(6):1007-15.
YAG laser treatment was conducted in 55 patients with central airway lesions over the last 8 years. The malignant lesions comprised 1 primary tracheal cancer, 1 chondroma of the trachea, 34 primary lung cancer, and 10 metastatic lung tumor. The benign lesions comprised one each of hamartoma, lipoma, bronchial lithiasis, post-tracheotomy granuloma, and bronchial web, and 3 other cases. Nd-YAG laser treatment was performed in 55 patients with airway lesions, with a success rate of 73%. The success rates in the above patients were 70% for primary lung cancer, 60% for metastatic lung tumor, 100% for primary tracheal cancer and chondroma of trachea, and 89% for benign lesions. In 34 patients with primary lung cancer, palliative widening of the airway was planned with the exception of 2 patients with endoscopically early lung cancer for whom curative vaporization was intended, 6 months-survival rate was 59.3% in patients in whom various combined treatments were performed after the laser treatment. For all patients with hamartoma or lipoma in those with benign lesions, curative vaporization was performed. The severe complication of lethal massive hemoptysis occurred in 3 patients. We consider that Nd-YAG laser treatment is a powerful therapeutic means of performing lifesaving or emergency, curative, and supplemental treatment.
在过去8年中，对55例中央气道病变患者进行了YAG激光治疗。恶性病变包括1例原发性气管癌、1例气管软骨瘤、34例原发性肺癌和10例肺转移瘤。良性病变包括错构瘤、脂肪瘤、支气管结石、气管切开术后肉芽肿、支气管蹼各1例，以及其他3例。对55例气道病变患者进行了Nd-YAG激光治疗，成功率为73%。上述患者中，原发性肺癌的成功率为70%，肺转移瘤为60%，原发性气管癌和气管软骨瘤为100%，良性病变为89%。在34例原发性肺癌患者中，除2例内镜下早期肺癌拟行根治性汽化外，其余均计划行姑息性气道扩张，激光治疗后行各种联合治疗的患者6个月生存率为59.3%。对良性病变中的所有错构瘤或脂肪瘤患者均行根治性汽化。3例患者发生了致命性大咯血这一严重并发症。我们认为Nd-YAG激光治疗是一种进行挽救生命或紧急、根治性及补充治疗的有力治疗手段。
