Clinical Analysis Of Holmium Laser Via Electronic Bronchoscopy In The Treatment Of Central Airway Stenosis

Purpose:To evaluate the short-term efficacy of Holmium laser via electronic bronchoscopy in the treatment of central airway stenosis caused by benign or malignant lesions.Methods:We choosed 10 patients definitely diagnosed as central airway stenosis by computerized tomography (CT) or Electronic bronchoscopy from July to December in 2014 in our hospital. Each patient had different degrees of dyspnea, stridor, hypoxemia and postobstructive pneumonia.There were benign lesions in 3 cases, lung cancer in 5 cases (including 2 cases of squamous carcinoma 2 cases of adenocarcinoma and 1 case of small cell lung cancer), and 2 cases of metastatic carcinoma from esophageal cancer. Treatment was performed with the Holmium laser via a flexible bronchoscope. In order to evaluate the efficacy of this therapy, dyspnea index, airway diameter,ABG, respiratory rate and HR were evaluated before the procedure and after the last operation. We also recorded the relief of the central airway stenosis. And after the procedure we had a follow-up for at least 3 months to make the evaluation of the incidence of reoccurring restenosis.Results:Over the study period,18 therapeutic procedures were performed. Each person had 1 or 3 times. After holmium laser therapy, patients with dyspnea had apparent remission. Dyspnea index decreased from (3.50±0.85) to (1.50±1.08)L (P <0.01),and airway diameter increased from (3.37±0.67) to (8.75±1.24)mm, (P< 0.01).The patient’s breathing rate decreased significantly after the last treatment and decreased from (22.10±2.33) to (16.70±0.82) (P<0.01). HR had decreased significantly from (87.90±4.61) to (73.40±7.43).The ABG of patients had improved apparenty. In the result, full effectiveness was achieved in 3 cases(30%), partial in 6 cases(60%) and mild in 1 cases(10%). During the operation, one person occurred temporary hyoxemia and two persons occurred sinus tachycardia. There were no hematorrhea and other serious complications. After the therapy, cases of patients had increased respiratory secretions and hemoptysis slightly, which can disapprear later. After a follow-up for 3 months,2 cases with benign lesions had reoccuring restenosis that were diagonosed by CT or bronchoscopy.Conclusions:The patients can get good short-term efficacy treated by holmium laser via the flexible electronic bronchoscope. It is a kind of effective and safe therapy to solve the central airway stenosis, which can heal the benign disease and can be used as a palliative for malignant disease.