呼吸器外科におけるレーザー治療と21世紀の展望

Abstract

One hundred and seventy-seven patients (79 primary lung cancers, 94 metastatic lung cancers and 4 benign tumors) underwent lung resection procedure using a Neodymium: yttrium aluminum-garnet (Nd: YAG) laser. Of the 79 patients with primary lung cancer, 44 patients with T1N0M0 disease underwent an intentional limited operation, a so-called“radical laser segmentectomy”. These patients showed a good 5-year survival rate of 88% without tumor recurrence at the lung's resected margin. The percentage of patients losing respiratory functions was significantly smaller in the laser segmentectomy group than in the standard lobectomy group. Of the 94 patients with metastatic lung cancer, 59 had multiple metastases. These patients had a better survival rate than the 32 patients that did not undergo laser surgery for multiple metastases. However, the difference did not reach a statistically significant level. Of the 177 patients, six experienced a prolonged air leakage as a complication, and of these 6 patients, 4 required an operation to repair the air leak. There was only one operative death. There was no bleeding during the perioperative period. In conclusion, the high-power Nd: YAG laser is effective both as a means for achieving high radicality, and for preserving lung function after lung surgery for malignant lesions.