Nd-YAG laser application in pulmonary and endobronchial lesions.

For recurrent pulmonary bleeding and recanalization of centrally obstructed or stenosed airways, endobronchial Nd-YAG laser irradiation through fiberoptic bronchoscopy was performed on 25 patients with malignant (n = 21) and benign (n = 4) disease of tracheobronchial lesions under topical anesthesia. Complete (n = 12) and partial (n = 6) restoration of the airway occurred in all 25 patients after photoresection therapy. For two patients with recurrent bleeding, the therapy resulted in immediate arrest of bleeding. For five patients the therapy resulted in unsuccessful recanalization because of rapidly recurring tumors. Two patients' conditions were complicated by respiratory insufficiency, one caused by smoke intoxication during laser vaporization and the other caused by tenacious rubberlike fibrinous plaque within a day after laser treatment. There was no mortality or perforation of the tracheobronchial wall after laser irradiation. Nd-YAG laser provides an additional tool in the palliative therapy for unresectable, obstructive malignant tumors and a procedure for avoiding extensive surgery in benign lesions.