Shapshay S M, Davis R K, Vaughan C W, Norton M, Strong M S, Simpson G T
Otolaryngol Head Neck Surg. 1983 Dec;91(6):615-9. doi: 10.1177/019459988309100605.
A CO2 laser rigid bronchoscope system has been used to palliate symptoms of a malignancy obstructing the tracheobronchial airway. Fifty-nine endoscopic laser operations (34 patients) were done between 1975 and 1981. Severe dyspnea and obstructive atelectasis were the most common indications for treatment. Contraindications for treatment included extrinsic tracheobronchial compression, widespread distant metastases, rapidly progressing tumors, and highly vascular neoplasms. There were nine primary tracheal malignancies, five metastases from distant sites, and 20 primary lung cancers with tracheobronchial obstructions. Most patients were previously treated with one or more standard modalities (radiation therapy, surgery, and chemotherapy). Removal of airway obstruction was occasionally indicated prior to radiation therapy to facilitate treatment. There were seven instances of complications in this group of patients and one mortality. Most patients (23 of 34) have died from their malignancy. The best palliation was achieved in proximal (tracheal and main stem bronchial), slower growing tumors.
二氧化碳激光硬质支气管镜系统已被用于缓解阻塞气管支气管气道的恶性肿瘤的症状。1975年至1981年间进行了59例内镜激光手术（34例患者）。严重呼吸困难和阻塞性肺不张是最常见的治疗指征。治疗的禁忌证包括气管支气管外压、广泛远处转移、快速进展的肿瘤和高血管性肿瘤。有9例原发性气管恶性肿瘤、5例远处转移灶和20例伴有气管支气管阻塞的原发性肺癌。大多数患者此前接受过一种或多种标准治疗方式（放射治疗、手术和化疗）。在放射治疗前偶尔需要解除气道阻塞以促进治疗。该组患者中有7例出现并发症，1例死亡。大多数患者（34例中的23例）死于恶性肿瘤。近端（气管和主支气管）生长较慢的肿瘤获得了最佳的缓解效果。
