Abstract: Poster Presentations |

Successful Application of Flexible Bronchoscopic Dilatation And Tracheobronchial Stenting With The Utilization of Newer Holmium-YAG Laser In the Relief of Symptoms From Tracheobronchial Obstructive Lesions FREE TO VIEW

Shamsuddin Khwaja, MD*; Alykhan S. Nagji, BS; Michelle C. Paul, BS; Rehal A. Bhojani, BS; John E. Hoopman, BS; Michael A. Wait, MD; J. M. DiMaio, MD
Author and Funding Information

University of Texas Southwestern Medical Center, Dallas, TX


Chest. 2004;126(4_MeetingAbstracts):823S. doi:10.1378/chest.126.4_MeetingAbstracts.823S
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PURPOSE:  Tracheobronchial obstructive lesions cause significant patient discomfort and increased morbidity. The Holmium-YAG laser has a depth of penetration and optic visualization that allows precise and controlled ablation of tissue. This is the largest case series describing the application of Holmium-YAG laser for tracheobronchial obstructive disease.

METHODS:  A retrospective analysis of patients undergoing surgical treatment of tracheobronchial obstruction from benign and malignant conditions. The study period was over 28 months. We utilized flexible bronchoscopy and Holmium-YAG laser.

RESULTS:  34 patients were treated. Average age was 55.6 ± 10.5 years (range 36-75). Twenty-seven (79%) had cancer, 18 had primary lung cancer. Seven patients had airway obstruction secondary to benign conditions. Eighty-five percent had American Society of Anesthesiologists (ASA) score of 3 or 4. Pre-operative pneumonia was present in 38% and 18% had lung consolidation. Total of 57 procedures were performed. Holmium-YAG laser was used in 46 procedures –26 laser only and 20 with laser plus stenting. There was 1 (2.9%) operative death, 30-day mortality was 6/34 (17.6%), and hospital mortality was 7/34 (20.6%). Post-operative relief of symptoms was completely determined in 22 patients. Twenty patients had immediate improvement, 1 was worse, and 1 had no change in breathing. Average hospital stay was 3.6 ± 8.4 days (range 0-59).

CONCLUSION:  Patients presenting with tracheobronchial obstruction in general have poor pre-operative functional status with significant discomfort. In this select group, symptomatic relief in breathing and functional status can be provided by the application of the newer Holmium-YAG laser combined with tracheobronchial dilation and stenting.

CLINICAL IMPLICATIONS:  This new technique enables a physician to open and maintain an airway that was previously inaccessible. It provides a reasonable technique that appears safe and effective.

DISCLOSURE:  S. Khwaja, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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