Endobronchial therapy with a thulium fiber laser (1940 nm)

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• 作者：Wolfgang Gesierich ; MD^a ; ^{w.gesierich@asklepios.com" class="auth_mail} ; Frank Reichenberger ; MD^a ; Andreas Fertl ; MD^c ; Karl Haeussinger ; MD^a ; Ronald Sroka ; PhD^b
• 关键词：15.2 ; 15.3 ; 15.5 ; 15.8
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：June 2014
• 年：2014
• 卷：147
• 期：6
• 页码：1827-1832
• 全文大小：432 K

文摘

Nd:YAG laser (1064 nm) is standard in bronchology. The thulium fiber laser (1940 nm) has a nearly 1000-fold increased absorption in water, enabling precise tissue ablation with a small margin of coagulation, whereas 1064-nm laser light penetrates deeper into tissue with less controllable effects.

bsSec_2">Objectives

bspara0015">To assess the safety, feasibility, and versatility of endobronchial thulium laser therapy in an observational cohort study.

bsSec_3">Methods

bspara0020">Endobronchial treatment with the thulium fiber laser was performed in a cohort study of 187 bronchoscopies on 132 consecutive patients with 135 endobronchial lesions amenable to laser resection.

bsSec_4">Results

bspara0025">The thulium fiber laser produced superficial, precise, and rapid tissue ablation. Eighty-one lesions were completely vaporized; 82 lesions were treated by deep tissue destruction by inserting the fiber into tissue followed by mechanical resection. Tumor bleeding was coagulated with rapid and sustained hemostasis (n = 28). Nitinol stents were removed after resection of severe granulation tissue overgrowth (n = 10). Intact stents were maintained after ablation of in-stent tissue (n = 47). In 11 cases, bleeding occurred during laser treatment (n = 11 of 187). Power settings between 5 and 20 W were found to be safe.

bsSec_5">Conclusions

bspara0030">Endobronchial therapy with the thulium laser at 1940 nm seems to be safe, feasible, and highly versatile for treatment of airway stenosis and stent obstruction caused by tissue ingrowth. Further studies are warranted.