Nd-YAG Laser Therapy Research Articles

A Case of Endobronchial Tuberculosis with Cicatricial Stenoses Successfully Treated by Combination of Endoscopic Nd-YAG Laser and Balloon Dilatation Therapy

A Case of Endobronchial Tuberculosis with Cicatricial Stenoses Successfully Treated by Combination of Endoscopic Nd-YAG Laser and Balloon Dilatation Therapy

A Case of Endobronchial Hamartoma Removed by Bronchoscopic Nd-YAG Laser Therapy and Electrosurgical Snaring

A Case of Endobronchial Hamartoma Removed by Bronchoscopic Nd-YAG Laser Therapy and Electrosurgical Snaring

Watermelon stomach following and preceding systemic sclerosis

Objectives: To report two patients with watermelon stomach associated with systemic sclerosis (SSc) and review the literature on that subject. Methods: We describe the clinical presentation, course and outcome of our two patients and reviewed the medical literature registered in the MedLine PubMed database from 1966 to 1999 by using the key words watermelon stomach, gastric antral vascular ectasia, systemic sclerosis, scleroderma.Results: The two patients presented with microcytic hypochromic anemia. Esophagogastroscopy showed multiple linear vascular malformations in the antrum compatible with watermelon stomach. They responded to Nd-Yag laser therapy with resolution of the lesions and improvement of the anemia. Patient 1 had a history of diffuse SSc while patient 2 developed limited SSc 2 years after the diagnosis of watermelon stomach. A literature review disclosed 16 documented case reports of watermelon stomach associated with SSc, 14 of whom were women. In most cases, watermelon stomach occurred in patients with established SSc but in some it antedated it by several years. In many cases, other autoimmune syndromes such as hypothyroidism, primary biliary cirrhosis, and Sjögren's syndrome were present. The presenting symptom was iron deficiency anemia, which in 11 cases was severe enough to require blood transfusions. Nine patients were successfully treated with several transendoscopic treatments, four required surgical intervention, and in three treatment was not specified. Conclusion: Although watermelon stomach is a rare syndrome, it is recognized as a cause of persistent bleeding in patients with SSc. Awareness of this condition may increase its recognition and treatment. Semin Arthritis Rheum 30:127-131. Copyright © 2000 by W.B. Saunders Company

Localized Amyloidosis Associated with Endobronchial and Pulmonary Parenchymal Masses

We describe a 73-year-old man who presented with an unusual combination of bronchopulmonary amyloidosis and endobronchial mass in the left bronchus, which caused atelectasis of the left lung, and a pulmonary parenchymal mass in the left lung. Nd-YAG laser therapy was performed to photocoagulate the endobronchial lesion. Two years later, the endobronchial mass in the left bronchus caused pneumonia of the left basal segment. Left lower lobectomy was performed.

A Case of Endobronchial Hamartoma, Successfully Treated with Endoscopic Nd-YAG Laser and Low Wave-length KTP Laser Therapy

A Case of Endobronchial Hamartoma, Successfully Treated with Endoscopic Nd-YAG Laser and Low Wave-length KTP Laser Therapy

A Case of Tracheal Papillomas Treated With Bronchofibroscopic Nd-YAG Laser Therapy

In contrast to juvenile laryngeal papillomatosis, which occurs most often in children and teenagers and is usually self limited, soliatry papillomas in adults are one of uncommon tumors of airway, and have a higher incidence of cancer. They are caused by the respiratory infection of human papilloma virus(HPV). They could spread to more distal airways and have a tendency of recurrence after limited surgical excision. Recently endoscopic therapies such as Nd-YAG laser, electrocautery, and cryotherapy provide extremely effective treatment modalities. We report a case of solitary tracheal papillomas in a 48 year-old man who presented with cough, scanty hemoptysis, and functional evidence of central airway obstruction. He was successfully treated by a Nd-YAG laser therapy via fiberoptic bronchoscopy under the local anesthesia.

レーザー治療後外科治療を施行した超高齢者肺癌の 1 例

レーザー治療後外科治療を施行した超高齢者肺癌の 1 例

Radiofrequency resection of bronchial tumours in combination with cryotherapy: evaluation of a new technique.

BACKGROUND: A number of treatments, including Nd-YAG laser therapy, brachytherapy, cryotherapy, electrocautery, and photodynamic therapy, can re-open the obstructed bronchial lumen in patients with inoperable obstructive bronchial tumours. None of...

ＱＯＬからみた気道・食道疾患治療の新戦略 ＱＯＬからみた気管，食管支腫ように対する各種治療法の選択

Surgical resection is the treatment of choice for tracheal and bronchogenic carcinoma. However, there are several inoperable cases because of poor performance status due to severe tumor invasion, or aging.On the other hand, an increasing number of early-stage lung cancer cases is being detected as a result of improved survey and diagnostic techniques. In patients with limited pulmonary function, it would therefore be beneficial to reduce the extent of resection, thereby preserving pulmonary function.Patients with severe respiratory distress, immediate Nd-YAG laser therapy and/or stenting is the first choice to improve their performance status, and PDT provides an alternative to surgical resection as the primary treatment for patients with early-stage central-type lung cancer.Considering the quality of life of such patients, the role of conservative treatments such as laser therapy, brachy therapy and stenting are discussed in this paper.

522 High dose-rate (HDR) endobronchial brachytherapy associated or not with previous Nd-YAG laser therapy for lung cancer: Results and complications of a prospective study

522 High dose-rate (HDR) endobronchial brachytherapy associated or not with previous Nd-YAG laser therapy for lung cancer: Results and complications of a prospective study

Nd-YAG Laser Therapy for Tracheobronchial Stenosis Caused by Tuberculosis

Fibrostenosis of the large airways due to tuberculosis is one of the most challenging clinical problems. It can lead to respiratory failure and is often difficult to manage. No single technique, such as balloon dilatation or insertion of self-expandable metallic stents, has proven totally satisfactory in the management of fibrostenosis. We classified fibrostenosis into three types based on bronchoscopic findings (a) stenosis due to fibrous diaphragms with sparing of the tracheobronchial wall (diaphragm type), (b) stenosis by collapse of the wall secondary to destruction of cartilage (collapse type), and (c) stenosis by nonspecific scar tissue in the lumen with collapse of the wall (combined type). We have treated 10 patients with dyspnea due to severe fibrostenosis of the diaphragm or the combined type using Nd-YAG laser through a flexible bronchoscope. Eight of 10 patients improved after laser therapy. Airway patency was maintained during a follow-up period averaging 31.9 months. There were no serious complications as a result of therapy. The results of our present study indicate that Nd-YAG laser therapy is an effective and safe method for the management of tuberculous fibrostenosis in selected cases.

上唇部リンパ管腫に対する Nd-YAG レーザー療法

In this paper, Nd-YAG laser therapy for a case of lympangioma of the upper lip was reported. The patient was a 9-year-old male with a tumor measuring 30×20mm on the right upper lip. Histological diagnosis of a biopsied specimen was cavernous lymphangioma. The patient underwent photocoagulation therapy with Nd-YAG laser, because OK 432 local injection therapy had been ineffective. The postoperative course was uneventful and he had no postoperative deformity and dysfunction.

Nd-YAG laser as a palliative treatment for malignant dysphagia

Two hundred and twenty-four patients with histologically-confirmed carcinoma of the oesophagus received palliative Nd-YAG laser therapy for malignant dysphagia between January 1986 and December 1994. The results are appraised in terms of the degree of relief obtained, its relation to the macroscopic type and the size of the tumour, peri-operative complications, duration of hospitalization and survival after treatment. Recannulation of the oesophageal lumen was obtained in 98.2% of the patients, after which 93.7% were able to ingest at least semi-solids. Although the lumen was permeable for a 9.8 mm endoscope, the remainder could only ingest liquids. The only complication was a perforation is six cases (2.7%). After treatment, 14.8% survived more than 1 year and 3.4% more than 2 years. After discussing the role of lasers in the palliative treatment of malignant dysphagia, the authors conclude that it can be considered effective in that it relieves the dysphagia and improves the patients' quality of life.

Nd-YAG レーザー焼灼術施行後切除した気管腺様嚢胞癌の 1 例

Nd-YAG レーザー焼灼術施行後切除した気管腺様嚢胞癌の 1 例

Bronchoscopic Therapy in Patients With Intraluminal Typical Bronchial Carcinoid

To study the efficacy of bronchoscopic therapy in patients with intraluminal typical bronchial carcinoid. Retrospective analysis of the data of patients with bronchial carcinoid, treated primarily with bronchoscopic techniques such as Nd-YAG laser in various hospitals in the Netherlands. Eleven patients with pulmonary complaints, ages 22 to 60 years, who were found to have intraluminal typical bronchial carcinoid. BRONCHOSCOPIC INTERVENTIONS: Six of the 11 patients received Nd-YAG laser treatments, one received Nd-YAG laser plus photodynamic therapy, and the other four had mechanical tumor removal. Six patients were surgically treated after bronchoscopic therapy. The resected specimens showed no residual carcinoid. Median follow-up has been 70 months (range, 9 to 170 months). Five patients were not surgically treated after bronchoscopic therapy. Follow-up has been 27 to 246 months (median, 47 months) without signs of recurrence. In 11 patients with typical, intraluminal, bronchial carcinoids, bronchoscopic treatment seemed to result in excellent local control, with surgical proof of cure in 6 of 11 patients. Bronchoscopic approach may provide a tissue-sparing alternative for bronchoplastic surgery in a subset of patients with typical intraluminal bronchial carcinoids.

早期胃癌に対する内視鏡的切除法および Nd-YAG レーザー併用例の検討

The clinical course of early gastric cancer treated by endoscopic resection and combined with Nd-YAG laser was evaluated. Included in the present study were 101 patients treated be endoscopic resection alone, 16 who had surgery after endoscopic resection, and 14 in whom endoscopic resection was combined with the use of Nd-YAG laser. Fifty-six patients with elevated early gastric cancer were treated by endscopic resection alone. Excised en bloc was possible in 21 fo 28 patients with mucosal cancer measuring 10 mm or less. No residual cancer was found in the remaining 7 patients, in whom piecemeal resection was conducted. No residual cancer was detected in the patient with submucosal cancer as well. Excised en bloc was possible in 13 of 28 patients with cancers measuring 11-20 mm. Piecemeal resection was conducted in the remaining 15 patients. Excised en bloc and piecemeal resection were carried out in 4 patients each with cancers measuring 21 mm or greater. Forty-five patients with depressed gastric cancer could be treated by endoscopic resection alone. Excised en bloc could be conducted in 32 of 44 patients with mucosal cancer, while piecemeal resection was carried out in 12 patients. Excised en bloc was possible in 5 of 13 patients with cancers measuring 11-20 mm, Recurrence occurred in 2 patients, both subjected to piecemeal resection, in long-term follow-up. Residual cancer was noted in 10 of 16 patients in whom additional surgery was conducted. Recurrence of submucosal cancer was observed in 2 patients in whom Nd-YAG laser therapy was conducted at the same time.14 case were treated by combined therapy with Nd-YAG laser, tumor was removed completely in 12 cases.

ELEVEN CASES OF AIRWAY OBSTRUCTION DUE TO RECURRED ESOPHAGEAL CANCER TREATED WITH ND-YAG LASER

Eleven patients with tracheobronchial stenosis due to a recurrent malignant tumor following resection of an esophageal cancer were treated with neodymium-ytrrium-aluminium-garnet laser (Nd-YAG laser). Intermittent irradiation of Nd-YAG laser was done for 0.5 second at 20-30 Watt through a flexible bronchoscope under local anesthesia. After the recanalization of the airway, the laser therapy was repeated 2 to 16 times for every 14 to 21 days to avoid the recurrence of airway obstruction. The average survival time from the start of the laser therapy was 138 days and the median survival time was 83 days. The direct response for tumor size detected by CT-SCAN was not recognized but dyspnea of the patients was dramatically improved by the therapy. It is concluded that the endoscopic Nd-YAG laser therapy is useful in respiratory emergency for airway obstruction by recurrent malignant tumor after resection of esophageal cancer.

Survival of Patients Undergoing Nd-YAG Laser Therapy Compared With Nd-YAG Laser Therapy and Brachytherapy for Malignant Airway Disease

I read with interest the article by Shea et al 1 Shea JM Allen RP Thurratt RS Chan AL Siefkin AD. Survival of patients undergoing Nd YAG laser therapy compared with Nd YAG laser therapy and brachytherapy for malignant airway disease. Chest. 1993; 103: 1028-1031 Abstract Full Text Full Text PDF PubMed Scopus (64) Google Scholar in the April 1993 issue of Chest. The authors describe their experience with endobronchial therapy for exophytic inoperable squamous cell carcinoma of the lung with Nd-YAG plus or minus low dose brachytherapy. Their conclusions about longer survival of patients receiving combination therapy may be related to the deficiencies that exist in their study rather than a true benefit. I cite various factors that would affect survival of inoperable lung cancer and that are not addressed in their study.

Photodynamic therapy for villous adenomas of the colon and rectum.

Endoscopic thermal laser therapy of colorectal villous adenomas is associated with a high recurrence rate due to incomplete tumor ablation, as treatment over carries a risk of perforation. Photodynamic therapy has been shown to be a promising in the treatment of small malignant tumors, and may be useful for benign adenomas. Eight patients with nine colosigmoid villous adenomas measuring 1-5 cm in length were treated with photodynamic therapy using either haematoporphyrin derivative or Photofrin as photosensitizer and multiple (4-16) applications of interstitial photoirradiation with red light (630 nm, 100 mW x 500 s per application). All but one adenoma had previously been incompletely treated with Nd-YAG laser therapy. Some skin sensitivity to light was seen in one patient. Seven adenomas were eradicated (follow-up 9-56 months, median = 12) as judged by follow-up endoscopy and biopsy. No local complications were seen. Substantial necrosis was produced in the other two adenomas, but they were not completely destroyed, probably due to inadequate light. PDT holds promise in the non-surgical management of villous adenomas, particularly after initial tumour debulking with the Nd-YAG laser.

Effects of Bronchoscopic Nd-YAG Laser Therapy in Tuberculous Tracheobronchial Fibrostenosis

Background: Fibrostenosis of large airway due to tuberculosis is one of the most perplexing clinical problems not only because it can lead to respiratory failure but also because of difficulty in the management. No one technique, such as balloon dilatation or insertion of self expandable metallic stent, has proved totally satisfactory in the management of fibrostenosis. We evaluated the effect of laser therapy in patient with severe fibrostenosis due to tuberculosis. Method: We classified the fibrostenosis to three types by bronchoscopic finding - the diaphragm type: stenosed by fibrous diaphragm, sparing the tracheobronchial wall, the collapse type: stenosed by collapse of the wall due to destruction of the cartilage, and the combined type: stenosed by nonspecific inflammatory scar tissue within internal lumen with collapse of the wall. We have treated 10 patients complaining dyspnea due to with severe fibrostenosis of the diaphargm or the combined type using a neodymiumyttrium aluminum garnet(Nd-Y AG) laser through a flexible bronchoscopy. Results: Eight of the 10 cases improved after laser therapy and maintained during a follow up period of average 31.9 months. All of the cases undergoing laser therapy showed no serious complication to need the therapy. Conclusion: The results of our present study indicate that the Nd-YAG laser therapy is an effective and safe method for the management of selective tuberculous fibrostenosis.