The treatment of tracheobronchial obstruction with the neodymium (Nd)-yttrium aluminum garnet (YAG) laser

The Nd: YAG laser has been used over the past two years in over 100 patients to treat obstructive pathology in the tracheobronchial tree. The majority of procedures were done to palliate malignancy - symptoms of dyspnea, hemoptysis and obstructive pneumonia. Selected cases of benign pathology such as inflammatory stenosis and granulation tissue were also treated successfully. A flexible fiberoptic delivery system can be used for less threatening pathology but the open rigid bronchoscopic system with telescopic visual control is more suitable for major obstructing pathology in the trachea and main bronchi. There were no deaths directly attributable to the laser’s application - two patients dying in the postoperative period from delayed hemorrhage and myocardial infarction. The YAG laser with it’s superior coagulating qualities (compared to CO₂ and Argon lasers) appears to be the wavelength of choice when treating tracheobronchial obstruction.