RESULTS OF PULMONARY METASTASES RESECTION WITH THE ND: YAG LASER AND ELECTROCAUTERY

Abstract

Purpose. To assess the effectiveness of various techniques of surgery of pulmonary metastases based on the outcomes of surgery interventions, frequency of postoperative complications and overall survival of patients.Patients and methods. Ninety-seven patients with suspected lung metastases of known primary malignancies (47 men and 50 women, mean age of 46,5 years) were retrospectively included in two study groups between 1 January 2004 and 1 January 2016 and underwent pulmonary surgery with the Nd: YAG laser of the 1318 nm wavelength (Group A, n = 44) or with the electrocautery (Group B, n = 53).Results. A total of 151 operations were performed: 75 in Group A, 76 in Group B. The mean number of resected pul­monary lesions was 8,2 (95% CI: 5,2–11,1) in group A and 4,9 (95% CI: 3,7–6,0, p = 0,047) in group B. Additionally 87 lesions were evaporated due to small sizes (1–2 mm) in Group A. The mean time of surgery was 146 minutes in Group A and 113 minutes in Group B (p < 0,01).Post-surgery complications were diagnosed after 9 and 19 of interventions in Groups A and B, respectively. The most common complications were pneumonia, pneumothorax and subcutaneous emphysema. The number of Grade III com­plications according to Clavien-Dindo classification was 2 and3 inGroups A and B, respectively. The survival rates were computed for all patients: the one-year, three-year and five-year survival rates were 83,7%, 49,7% and 36,7%, respec­tively.Conclusion. The Nd:YAG laser with wavelength of 1318 nm allow extensive parenchymal resections without an increase in post-surgery complications and may have advantages in pulmonary metastasectomy, especially in patients with mul­tiple pulmonary lesions.