[Usefulness of Nd-YAG laser for the excision of multiple lung metastases and segmentectomy for primary lung cancer].

Since 1986, limited resection of 561 pulmonary metastases in 25 patients was performed with the neodymium:yttrium-aluminum-garnet (Nd-YAG) laser. Use of the laser enabled a local excision of both superficially located and deep-seated tumors that would otherwise have required segmentectomy or lobectomy for safe removal. As a result, the 5-year survival rate for these patients was 40.3%. Since 1988, we also developed laser segmentectomy to treat primary lung cancer, and performed this procedure on 25 lung cancer patients. Of those, twenty-one patients had T1N0 disease. All are alive now and have had no local recurrence. The pulmonary distortion, which leads to impairment and loss of pulmonary function, was minimal in laser resection when compared to other procedures such as stapled resection or the casual ligation-division technique. In conclusion, we have found the Nd-YAG laser to be an effective tool both for preserving pulmonary function and for obtaining clear safety margins.