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Use of Medical Lasers for Airway Disease

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Principles and Practice of Interventional Pulmonology

Abstract

Since the first description nearly half a century ago, medical lasers have become a vital component of the therapeutic armamentarium of interventional pulmonologists. Over this time, medical lasers have been utilized to relieve nearly every form of airway luminal obstruction with beneficial effect on patient symptoms. Through the review of more than 10,000 published airway laser applications, our collective understanding of the power of this technique has been refined. With the growing access to this powerful tool exists an obligation of the operator to fully realize the mechanism of how lasers work, appropriate indications, complications, techniques, safeguards, and outcomes of employing medical lasers for therapeutic effects in the airway. The following chapter provides a discussion of these points designed to serve as a reference for the interventionalist interested in the use of medical lasers.

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Suggested Reading

  1. Strong MS, Jako GJ, Polanyi T, Wallace RA. Laser surgery in the aerodigestive tract. Am J Surg. 1973;126:529–33.

    Article  PubMed  CAS  Google Scholar 

  2. Laforet EG, Berger RL, Vaughan CW. Carcinoma obstructing the trachea. Treatment by laser resection. N Engl J Med. 1976;294:941.

    Article  PubMed  CAS  Google Scholar 

  3. Jako GJ, Vaughan CW, Strong MS, Polanyi TG. Surgical management of malignant tumors of the aerodigestive tract with carbon dioxide laser microsurgery. Int Adv Surg Oncol. 1978;1:265–84.

    PubMed  CAS  Google Scholar 

  4. Toty L, Personne C, Colchen A, Vourc’h G. Bronchoscopic management of tracheal lesions using the neodymium yttrium aluminium garnet laser. Thorax. 1981;36:175–8.

    Article  PubMed  CAS  Google Scholar 

  5. Dumon JF, Reboud E, Garbe L, Aucomte F, Meric B. Treatment of tracheobronchial lesions by laser photoresection. Chest. 1982;81:278–84.

    Article  PubMed  CAS  Google Scholar 

  6. McDougall JC, Cortese DA. Neodymium-YAG laser therapy of malignant airway obstruction. A preliminary report. Mayo Clin Proc. 1983;58:35–9.

    PubMed  CAS  Google Scholar 

  7. Mehta AC, Golish JA, Ahmad M, Zurick A, Padua NS, O’Donnell J. Palliative treatment of malignant airway obstruction by Nd-YAG laser. Cleve Clin Q. 1985;52:513–24.

    Article  PubMed  CAS  Google Scholar 

  8. Shapshay SM. Laser applications in the trachea and bronchi: a comparative study of the soft tissue effects using contact and noncontact delivery systems. Laryngoscope. 1987;97(Suppl):1–26.

    Article  PubMed  CAS  Google Scholar 

  9. Cavaliere S, Foccoli P, Farina PL. Nd:YAG laser bronchoscopy. A five-year experience with 1,396 applications in 1,000 patients. Chest. 1988;94:15–21.

    Article  PubMed  CAS  Google Scholar 

  10. Brenner M, Shankel T, Wang NS, Waite TA, Wong H, Hamilton A, Tadir Y, Milner T, Boyajian J, Chung E, Tromberg B, Wilson AF, Berns MW. CO2 and Nd:YAG laser-induced pulmonary parenchymal lung injury in a rabbit model. Am J Respir Crit Care Med. 1996;153:1136–40.

    Article  PubMed  CAS  Google Scholar 

  11. Parrish JA, Walsh Jr JT. Potentials for progress in laser medicine. Yale J Biol Med. 1985;58:535–45.

    PubMed  CAS  Google Scholar 

  12. Bolliger CT, Sutedja TG, Strausz J, Freitag L. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation, and stents. Eur Respir J. 2006;27:1258–71.

    Article  PubMed  CAS  Google Scholar 

  13. Dumon JF, Shapshay S, Bourcereau J, Cavaliere S, Meric B, Garbi N, Beamis J. Principles for safety in application of neodymium-YAG laser in bronchology. Chest. 1984;86:163–8.

    Article  PubMed  CAS  Google Scholar 

  14. Feller-Kopman D, Lukanich JM, Shapira G, Kolodny U, Schori B, Edenfield H, Temelkuran B, Ernst A, Schindel Y, Fink Y, Fox J, Bueno R. Gas flow during bronchoscopic ablation therapy causes gas emboli to the heart: a comparative animal study. Chest. 2008;133:892–6.

    Article  PubMed  Google Scholar 

  15. Moghissi K, Pender D. Instrumental perforations of the oesophagus and their management. Thorax. 1988;43:642–6.

    Article  PubMed  CAS  Google Scholar 

  16. George PJ, Garrett CP, Nixon C, Hetzel MR, Nanson EM, Millard FJ. Laser treatment for tracheobronchial tumours: local or general anaesthesia? Thorax. 1987;42:656–60.

    Article  PubMed  CAS  Google Scholar 

  17. Brutinel WM, Cortese DA, McDougall JC, Gillio RG, Bergstralh EJ. A two-year experience with the neodymium-YAG laser in endobronchial obstruction. Chest. 1987;91:159–65.

    Article  PubMed  CAS  Google Scholar 

  18. Beamis Jr JF, Shapshay SM. More about the YAG. Chest. 1985;87:277–8.

    Article  PubMed  Google Scholar 

  19. McCaughan Jr JS, Heinzmann HG, McMahon D. Impacted broncholiths removed with the holmium: YAG laser. Lasers Surg Med. 1996;19:230–2.

    Article  PubMed  Google Scholar 

  20. Casey KR. Preventing endotracheal fires. Chest. 1987;91:637.

    Article  PubMed  CAS  Google Scholar 

  21. Kvale PA, Eichenhorn MS, Radke JR, Miks V. YAG laser photoresection of lesions obstructing the central airways. Chest. 1985;87:283–8.

    Article  PubMed  CAS  Google Scholar 

  22. Moghissi K, Dixon K. Bronchoscopic NdYAG laser treatment in lung cancer, 30 years on: an institutional review. Lasers Med Sci. 2006;21:186–91.

    Article  PubMed  CAS  Google Scholar 

  23. Madden BP, Kumar P, Sayer R, Murday A. Successful resection of obstructing airway granulation tissue following lung transplantation using endobronchial laser (Nd:YAG) therapy. Eur J Cardiothorac Surg. 1997;12:480–5.

    Article  PubMed  CAS  Google Scholar 

  24. Madden BP, Datta S, McAnulty G. Tracheal granulation tissue after percutaneous tracheostomy treated with Nd:Yag laser: three cases. J Laryngol Otol. 2001;115:743–4.

    Article  PubMed  CAS  Google Scholar 

  25. Madden BP, Lee M, Paruchuru P. Successful treatment of endobronchial amyloidosis using Nd:YAG laser therapy as an alternative to lobectomy. Monaldi Arch Chest Dis. 2001;56:27–9.

    PubMed  CAS  Google Scholar 

  26. Miks VM, Kvale PA, Riddle JM, Lewis Jr JW. Broncholith removal using the YAG laser. Chest. 1986;90:295–7.

    Article  PubMed  CAS  Google Scholar 

  27. Lennon RL, Hosking MP, Warner MA, Cortese DA, McDougall JC, Brutinel WM, Leonard PF. Monitoring and analysis of oxygenation and ventilation during rigid bronchoscopic neodymium-YAG laser resection of airway tumors. Mayo Clin Proc. 1987;62:584–8.

    Article  PubMed  CAS  Google Scholar 

  28. Vanderschueren RG, Westermann CJ. Complications of endobronchial neodymium-Yag (Nd:Yag) laser application. Lung. 1990;168(Suppl):1089–94.

    Article  PubMed  Google Scholar 

  29. Scherer TA. Nd-YAG laser ignition of silicone endobronchial stents. Chest. 2000;117:1449–54.

    Article  PubMed  CAS  Google Scholar 

  30. Witt C, Schmidt B, Liebetruth J, Baumann G. Nd:YAG laser and tracheobronchial metallic stents: an experimental in vitro study. Lasers Surg Med. 1997;20:51–5.

    Article  PubMed  CAS  Google Scholar 

  31. Hautmann H, Huber RM. Laser resistance of expandable metal stents in interventional bronchoscopy: an experimental evaluation. Lasers Surg Med. 2001;29:70–2.

    Article  PubMed  CAS  Google Scholar 

  32. Dalupang JJ, Shanks TG, Colt HG. Nd-YAG laser damage to metal and silicone endobronchial stents: delineation of margins of safety using an in vitro experimental model. Chest. 2001;120:934–40.

    Article  PubMed  CAS  Google Scholar 

  33. Young O, Kirrane F, Hughes JP, Fenton JE. KTP laser and nitinol alloy stents: are they compatible? Lasers Surg Med. 2007;39:803–7.

    Article  PubMed  Google Scholar 

  34. Tellides G, Ugurlu BS, Kim RW, Hammond GL. Pathogenesis of systemic air embolism during bronchoscopic Nd:YAG laser operations. Ann Thorac Surg. 1998;65:930–4.

    Article  PubMed  CAS  Google Scholar 

  35. Lang NP, Wait GM, Read RR. Cardio-cerebrovascular complications from Nd:YAG laser treatment of lung cancer. Am J Surg. 1991;162:629–32.

    Article  PubMed  CAS  Google Scholar 

  36. Mehta AC, Golish JA, Livingston DR. Loss of fiberoptic laser tip. Chest. 1985;88:798.

    Article  PubMed  CAS  Google Scholar 

  37. Mehta AC, Grimm M. Breakage of Nd-YAG laser sapphire contact probe inside the endobronchial tree. Chest. 1988;93:1119.

    Article  PubMed  CAS  Google Scholar 

  38. Livingston DR, Mehta AC, Golish JA, Ahmad M, Deboer G, Tomaszewski MZ. Palliation of malignant tracheobronchial obstruction by Nd-YAG laser: an update of experience at the Cleveland Clinic Foundation. J Am Osteopath Assoc. 1987;87:226–34.

    PubMed  CAS  Google Scholar 

  39. Lee P, Kupeli E, Mehta AC. Therapeutic bronchoscopy in lung cancer. Laser therapy, electrocautery, brachytherapy, stents, and photodynamic therapy. Clin Chest Med. 2002;23:241–56.

    Article  PubMed  Google Scholar 

  40. Shapshay SM, Beamis Jr JF. Safety precautions for bronchoscopic Nd-YAG laser surgery. Otolaryngol Head Neck Surg. 1986;94:175–80.

    PubMed  CAS  Google Scholar 

  41. Hujala K, Sipilä J, Grenman R. Endotracheal and bronchial laser surgery in the treatment of malign and benign lower airway obstructions. Eur Arch Otorhinolaryngol. 2003;260:219–22.

    PubMed  Google Scholar 

  42. Shapshay SM, Dumon JF, Beamis Jr JF. Endoscopic treatment of tracheobronchial malignancy. Experience with Nd-YAG and CO2 lasers in 506 operations. Otolaryngol Head Neck Surg. 1985;93:205–10.

    PubMed  CAS  Google Scholar 

  43. Personne C, Colchen A, Leroy M, Vourc’h G, Toty L. Indications and technique for endoscopic laser resections in bronchology. A critical analysis based upon 2,284 resections. J Thorac Cardiovasc Surg. 1986;91(5):710–5.

    PubMed  CAS  Google Scholar 

  44. Desai SJ, Mehta AC, VanderBrug Medendorp S, Golish JA, Ahmad M. Survival experience following Nd:YAG laser photoresection for primary bronchogenic carcinoma. Chest. 1988;94:939–44.

    Article  PubMed  CAS  Google Scholar 

  45. Shea JM, Allen RP, Tharratt RS, Chan AL, Siefkin AD. Survival of paients undergoing Nd:YAG laser therapy compared with Nd:YAG laser therapy and brachytherapy for malignant airway disease. Chest. 1993;103:1028–31.

    Article  PubMed  CAS  Google Scholar 

  46. Eichenhorn MS, Kvale PA, Miks VM, Seydel HG, Horowitz B, Radke JR. Initial combination therapy with YAG laser photoresection and irradiation for inoperable non-small cell carcinoma of the lung. A preliminary report. Chest. 1986;89:782–5.

    Article  PubMed  CAS  Google Scholar 

  47. Moghissi K, Dixon K, Hudson E, Stringer M, Brown S. Endoscopic laser therapy in malignant tracheobronchial obstruction using sequential Nd YAG laser and photodynamic therapy. Thorax. 1997;52:281–3.

    Article  PubMed  CAS  Google Scholar 

  48. Ross DJ, Mohsenifar Z, Koerner SK. Survival characteristics after Neodymium: YAG laser photoresection in advanced stage lung cancer. Chest. 1990;98:581–5.

    Article  PubMed  CAS  Google Scholar 

  49. Stanopoulos IT, Beamis JF, Martinez FJ, Vergos K, Shapshay SM. Laser bronchoscopy in respiratory failure from malignant aiway obstruction. Crit Care Med. 1993;21:386–91.

    Article  PubMed  CAS  Google Scholar 

  50. Han CC, Prasetyo D, Wright GM. Endobronchial palliation using Nd:YAG laser is associated with improved survival when combined with multimodal adjuvant treatments. J Thorac Oncol. 2007;2:59–64.

    Article  PubMed  Google Scholar 

  51. Fuks L, Fruchter O, Amital A, Fox BD, Rahman NA, Kramer MR. Long-term follow-up of flexible bronchoscopic treatment for bronchial carcinoids with curative intent. Diagn Ther Endosc. 2009;2009:782961.

    Article  PubMed  Google Scholar 

  52. Shapshay S, editor. Endoscopic laser surgery handbook. New York: Marcel Dekker; 1991. p. 1–131.

    Google Scholar 

  53. Dumon JF, editor. YAG laser bronchoscopy, Surgical science series, vol. 5. New York: Praeger Special Studies; 1985. p. 1–116.

    Google Scholar 

  54. Prakash UBS, editor. Bronchoscopy. New York: Raven; 1994. p. 279–91.

    Google Scholar 

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Correspondence to Jeffrey B. Hoag M.D., M.S., F.C.C.P. .

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Hoag, J.B. (2013). Use of Medical Lasers for Airway Disease. In: Ernst, A., Herth, F. (eds) Principles and Practice of Interventional Pulmonology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4292-9_35

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  • DOI: https://doi.org/10.1007/978-1-4614-4292-9_35

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