Palliation of Airway Obstruction from Tracheobronchial Malignancy: Use of the CO2 Laser Bronchoscope

Author:

Shapshay Stanley M.1,Davis R. Kim2,Vaughan Charles W.3,Norton Martin4,Strong M. Stuart5,Simpson George T.6

Affiliation:

1. From the Departments of Otolaryngology, Lahey Clinic Medical Center.

2. From the Walter Reed Army Medical Center.

3. From the Boston Veterans Administration Medical Center.

4. From the Department of Anesthesiology, University of Michigan Medical Center.

5. From the University Hospital.

6. From the Boston City Hospital.

Abstract

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.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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