Management of benign and malignant lesions of the trachea and bronchi with the neodymium-yttrium-aluminum-garnet laser.

Fifty patients with lesions of the trachea or bronchi have been treated with the neodymium-yttrium-aluminum-garnet laser. Forty-three patients had advanced carcinoma of the lung with pulmonary infection or abscess distal to an obstructing bronchial lesion or else had hemoptysis. Benign lesions were seen in seven patients. A total of 72 laser treatments were administered for obstruction and/or hemoptysis. There was no significant morbidity and only one hospital death occurred, which was unrelated to the laser therapy. Among the 43 patients with malignant disease, obstructive complications and hemoptysis were controlled in 39. All those with benign lesions have been significantly improved. Presently 22 patients with malignant disease remain alive and are symptomatically improved. The longest survival after successful laser treatment has been 73 weeks, and 34 survived longer than eight weeks. This laser is a very effective means of managing patients with benign lesions and offers significant palliation for patients with hemoptysis and advanced obstructing carcinoma of the trachea or main-stem bronchus.