Amemiya R, Oho K, Tsuboi M, Nagai K, Okitsu H, Koshiishi Y, Matsushima Y
Department of Surgery, Ibaraki Prefectural Central Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Jun;30(6):999-1006.
Between April 1980 and November 1990, we treated 212 cases of airway lesion using an Nd-YAG laser via the fiberoptic bronchoscope. The Nd-YAG laser power output was usually 40 W (20-60 W) delivered in 2 sec. shots. The cases consisted of 98 primary lung cancer, 12 primary tracheal cancer, 53 metastatic airway lesion, 7 benign tumor, and 42 cicatricial and granulomatous lesions. The therapeutic effects of Nd-YAG laser treatment were evaluated based on alleviation of dyspnea, widening of airway, and curative vaporization for therapeutic purposes. Effectiveness was observed in 180 of a total of 212 cases (84.9%). Out of 75 emergency cases in which a lifesaving procedure was performed to widen the airway, effective results were obtained in 70 (93.3%) with dramatic improvement in condition. It was also effective in 90 of 109 cases (82.6%) in which the procedure was performed for staged (palliative) widening of airway. In 55 cases of advanced lung cancer (Stage III or IV, mainly non-small cell cancer) in which palliative widening procedure was performed, one year survival was 44%. In 13 of 18 cases (72.2%) in which the procedure was performed for curative vaporization of invasive cancer, successful results were obtained. In 7 cases of benign tumor in which vaporization was performed as a radical curative procedure, no recurrence was observed in any cases. In 53 cases of metastatic airway lesion, effective results were obtained 48 (90.6%). The primary lesions of these cases consisted of 14 cases of esophageal cancer, 9 cases of lung cancer, 7 cases of colo-rectal cancer, 7 cases of thyroid cancer, and 16 others.(ABSTRACT TRUNCATED AT 250 WORDS)
1980年4月至1990年11月期间,我们通过纤维支气管镜使用Nd-YAG激光治疗了212例气道病变。Nd-YAG激光输出功率通常为40瓦(20 - 60瓦),每次发射持续2秒。病例包括98例原发性肺癌、12例原发性气管癌、53例转移性气道病变、7例良性肿瘤以及42例瘢痕性和肉芽肿性病变。基于呼吸困难的缓解、气道扩张以及为治疗目的进行的根治性汽化来评估Nd-YAG激光治疗的效果。212例患者中,180例(84.9%)观察到治疗效果。在75例为拓宽气道而进行挽救生命操作的急诊病例中,70例(93.3%)取得了有效结果,病情显著改善。在109例为分期(姑息性)拓宽气道而进行该操作的病例中,90例(82.6%)有效。在55例进行姑息性拓宽操作的晚期肺癌(Ⅲ期或Ⅳ期,主要为非小细胞癌)病例中,一年生存率为44%。在18例为浸润性癌进行根治性汽化的病例中,13例(72.2%)取得了成功结果。在7例作为根治性手术进行汽化的良性肿瘤病例中,无一例复发。在53例转移性气道病变病例中,48例(90.6%)取得了有效结果。这些病例的原发病变包括14例食管癌、9例肺癌、7例结直肠癌、7例甲状腺癌以及16例其他癌症。(摘要截选至250字)