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Pulmonology Procedures |

The Utility of the Potassium Titanyl Phosphate Laser in the Management of Central Airway Obstruction

Neil Ninan*, MD; Kamran Mahmood, MD; Scott Shofer, MD; Matthew Beyea; Momen Wahidi, MD
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Duke University Medical Center, Durham, NC


Chest. 2012;142(4_MeetingAbstracts):914A. doi:10.1378/chest.1389675
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Abstract

SESSION TYPE: Bronchoscopy and Interventional Procedures Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Obstruction of the trachea and mainstem bronchi can result from multiple etiologies, most notably malignancy. Various therapies delivered via flexible and rigid bronchoscopy have been employed in the management of central airway obstruction (CAO). This pilot study examines the use of the potassium titanyl phosphate (KTP) laser in the management of CAO.

METHODS: Patients with CAO undergoing rigid bronchoscopy were prospectively enrolled. All participants completed spirometry, Eastern Cooperative Oncology Group (ECOG) performance status score, short form-36 (SF-36) questionnaire, and the San Diego shortness of breath questionnaire (SOBQ) prior to the procedure and again at 4 weeks post-procedure. The KTP laser settings for pulse energy, width, and per second rate were identical for each subject. All procedures were performed by an experienced operator. Data on intraoperative and post-procedural complications was recorded.

RESULTS: Four subjects underwent rigid bronchoscopy with the KTP laser employed for the management of CAO. Three subjects had primary pulmonary malignancies and 1 subject had metastatic melanoma as the cause of CAO. Both FEV1 and FVC improved significantly (p=0.04 and 0.03, respectively). There was also improvement on the SOBQ and SF-36 scores. A single parameter on the SF-36, physical health, worsened. The mean ECOG score remained unchanged. There were no intraoperative or post-procedural complications.

CONCLUSIONS: There were significant improvements in FEV1 and FVC, as well as improvements in quality of life data. The unchanged ECOG score and decreased score on the physical health parameter of the SF-36 questionnaire are likely related to therapies administered for malignant disease initiated prior to the 4 week follow-up visit. We conclude that the KTP laser is effective for the management of CAO.

CLINICAL IMPLICATIONS: The KTP laser is a safe and effective tool for the managnement of malignant CAO.

DISCLOSURE: The following authors have nothing to disclose: Neil Ninan, Kamran Mahmood, Scott Shofer, Matthew Beyea, Momen Wahidi

No Product/Research Disclosure Information

Duke University Medical Center, Durham, NC

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