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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tracheobronchial obstruction resulting from esophageal carcinoma is uncommon. Patients with advanced esophageal carcinoma with tracheobronchial obstruction usually present with severe dyspnea or hemoptysis or both and may die of suffocation. The Lahey Clinic experience using laser bronchoscopy for the palliation of symptoms of airway obstruction in patients with esophageal carcinoma is presented. From 1982 to 1990, nine patients were treated in 13 procedures using the neodymium: yttrium-aluminum-garnet laser. Of the patients, seven had undergone previous treatment of the primary tumor. Tumors were located in the trachea in seven patients and in the main stem bronchi in three patients. Improvement of the airway caliber was achieved in all patients with relief of the dyspnea. The mean hospital stay was 2 days. One patient lived 4 years after laser treatment with no recurrence of tumor, and one patient died 1 week after treatment as a result of his poor general condition. The rest of the patients lived 3 to 41 weeks, with a median survival of 35 weeks. No complications were related to the procedures, and in particular, no tracheoesophageal fistulas developed. Our experience indicates that bronchoscopic application of this laser in conjunction with other treatment modalities can improve the quality and duration of life in selected patients with esophageal carcinoma that invades and obstructs the trachea.
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PMID:Tracheobronchial obstruction from esophageal carcinoma: bronchoscopic treatment with neodymium: yttrium-aluminum-garnet laser. 137 56

The Lahey Clinic experience using laser bronchoscopy for relief of obstructive tracheobronchial lesions during a 7-year period from 1982 to 1989 involves 269 patients treated with 400 procedures. The carbon dioxide (CO2) laser was used for tracheal stenosis and granulation tissue. The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used for all obstructing endobronchial neoplasms. Indications for therapy included severe dyspnea, hemoptysis, and postobstructive pneumonitis. All patients had relatively central lesions. A rigid bronchoscope was used to treat 88% of patients, and 12% of patients were treated with a flexible bronchoscope. One death occurred during the intraoperative period. Eleven deaths occurred within 1 week of therapy and were related to the presence of extensive malignant lesions or to coronary artery disease. Our experience indicates that bronchoscopic application of the CO2 or Nd:YAG laser affords effective palliation for patients with obstructive tracheobronchial lesions. The Nd:YAG laser is recommended for patients with bulky vascular endobronchial neoplasms, and the CO2 laser is best reserved for patients with benign tracheal stenosis and granulation tissue.
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PMID:Endoscopic laser therapy for obstructing tracheobronchial lesions. 170 56

Fifty patients with lesions of the trachea or bronchi have been treated with the neodymium-yttrium-aluminum-garnet laser. Forty-three patients had advanced carcinoma of the lung with pulmonary infection or abscess distal to an obstructing bronchial lesion or else had hemoptysis. Benign lesions were seen in seven patients. A total of 72 laser treatments were administered for obstruction and/or hemoptysis. There was no significant morbidity and only one hospital death occurred, which was unrelated to the laser therapy. Among the 43 patients with malignant disease, obstructive complications and hemoptysis were controlled in 39. All those with benign lesions have been significantly improved. Presently 22 patients with malignant disease remain alive and are symptomatically improved. The longest survival after successful laser treatment has been 73 weeks, and 34 survived longer than eight weeks. This laser is a very effective means of managing patients with benign lesions and offers significant palliation for patients with hemoptysis and advanced obstructing carcinoma of the trachea or main-stem bronchus.
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PMID:Management of benign and malignant lesions of the trachea and bronchi with the neodymium-yttrium-aluminum-garnet laser. 241 64

Neodymium-yttrium-aluminum-garnet laser treatments were performed in 70 patients aged 62 +/- 10 (1 SD) years for incomplete malignancy-induced obstruction of the trachea or main bronchi, or both, associated with uncontrolled cough, dyspnea, atelectasis/pneumonia, and hemoptysis. Forty-three patients had been treated with surgical techniques, chemotherapy, or radiotherapy, or all three, while 27 patients were untreated before laser therapy because of acute respiratory distress. Laser treatment produced palliative improvement in 81% of the treated group (35 of 43), with survival of 4.3 +/- 3.9 months. Unsuccessfully laser-treated patients survived 0.7 +/- 0.4 month (p less than .05). Eighty-five percent of the untreated patients (23 of 27) showed postlaser improvement, with survival of 8.5 +/- 6.9 months. Unsuccessfully laser-treated patients survived 1.4 +/- 0.6 months (p less than .05). Twenty-three of the 27 previously untreated patients underwent radiation therapy after laser treatment. Laser treatments also were administered to 23 patients aged 61 +/- 13 years with complete obstruction of the main bronchi. Of this group, 17 patients had been treated and 6 had not been treated before the laser therapy. Laser treatment was successful in 47% of the treated patients (8 of 17), but there was no difference (p greater than .05) in survival between successfully and unsuccessfully treated patients (3.0 +/- 2.5 vs. 2.9 +/- 4.6 months). Similarly, laser treatment was successful in 50% of the untreated patients (3 of 6), and there was also no difference (p greater than .05) in survival between successfully and unsuccessfully treated patients (3.4 +/- 3.5 vs. 3.5 +/- 2.8 months).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neodymium-yttrium-aluminum-garnet laser in lung cancer. 243 45

This study summarizes our experience in the evolution of a management technique for unresectable or recurrent lung cancer using the neodymium-yttrium-aluminum-garnet (Nd-YAG) laser with high-dose endobronchial brachytherapy. The laser gave good palliation for hemoptysis and obstruction with a low complication rate, and the addition of endobronchial radiotherapy was a useful adjunct for maintaining airway patency. High-dose brachytherapy delivered by the Gammamed IIi remote afterloader proved to be the best method of delivering this treatment.
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PMID:Management of airway problems in lung cancer patients using the neodymium-yttrium-aluminum-garnet (Nd-YAG) laser and endobronchial radiotherapy. 246 71

Laser technology and the endoscope have been combined for the palliation of obstructive tracheobronchial malignant lesions. The neodymium-yttrium-aluminum-garnet (Nd-YAG) laser was used to treat 249 patients (447 operations), and the CO2 laser was used on 34 patients (59 operations). Hemorrhage, the major complication in both groups of patients, was more easily controlled with the Nd-YAG laser. One patient in the CO2 laser group died, and one patient in the group being treated with Nd-YAG laser bronchoscopy died. The Nd-YAG laser can be applied more efficiently through a fiber system, with better optic control and secure hemostasis. The commonest indications for treatment were dyspnea, obstructive pneumonia, and hemoptysis. Extrinsic compression was the most frequent reason for failure. The Nd-YAG laser, most often applied through open rigid bronchoscopes under general anesthesia, has become our treatment of choice for the palliation of tracheobronchial malignancy.
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PMID:Endoscopic treatment of tracheobronchial malignancy. Experience with Nd-YAG and CO2 lasers in 506 operations. 258 Dec 12

Animal experiments were performed with evaluation of the use of the neodymium-YAG (yttrium-aluminum-garnet) laser in the trachea, bronchi, and pulmonary parenchyma. Histologic evaluation of incisions into the lung was assessed by multiple sections over a 5-week period and comparisons were made of incisions closed with chronic catgut or coagulated with electric cautery or by the laser. These studies indicated that the laser is more effective in controlling parenchymal bleeding and air leaks than either the cautery or chromic catgut and produces less local tissue reaction. The Nd-YAG laser has been used clinically to treat patients with inoperable obstructing and bleeding carcinomas of the trachea and main bronchi to open the involved airway and to restore pulmonary function. Fifteen patients have had 26 treatments using the Nd-YAG laser. Total laser time was limited to 15 minutes with 0.5-second pulses of 50 to 80 watts being delivered via the fiberoptic and straight bronchoscope as indicated. It is extremely effective in controlling hemoptysis from recurrent endobronchial lesions, and obstructing lesions in the trachea and main stem bronchus can be treated quite successfully with excellent palliation. It is apparent that continued clinical use of the Nd-YAG laser as palliative therapy for bleeding and obstructing tumors of the tracheobronchial tree is indicated and expanded use at the time of thoracotomy to control lung parenchymal bleeding and air leaks should be considered in the future.
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PMID:Experimental and clinical use of the YAG laser in the management of pulmonary neoplasms. 620 49

The method of endobronchial laser therapy with the use of photosensitiser-photosense (phthalocyanine aluminum)--was used since 1998 for the first time in faculty surgical clinic, as preoperative preparation in 36 patients with surgical diseases of the lungs (malignant and benign tumors and chronic inflammatory diseases). The method aimed at elimination of postoperative pyogenous complications and improvement of the respiratory system functional. The method consists in introduction into the organism by various ways the photosensitizing preparation photosence, followed by irradiation of the right and left parts of bronchial tree by low intensity laser light, (wave length 675 mm) through dispersing light guide, introduced through the flexible bronchoscope to the areas of the ostia of the lobar bronchi. 3 ways of introduction of the photosensitizer were used: endobronchial (9 patients); aerosol (22 patients); combination of the endobronchial lavage and intravenous injection (5 patients). The duration of the procedure of irradiation made up 5 min. at each side of the bronchial tree, the power density being 85 mV/cm2. The procedure was repeated twice for 2 days. The following results were obtained: antibacterial effect; reduction of endoscopic and morphological features of inflammation of the bronchial mucosa; stimulation of local immunity; decrease of the tumor aggression (according to histological examination); the appearance of the tumor destruction areas; lavering of Ki-67 and bcl-2, increase of c-bax; the improvement of the respiratory system functional; positive dynamics of clinical status (a decrease of cough, dispnea, quantity of mucus discharge and haemoptysis). The perspectiveness of the method is stressed as a preoperative preparation in patients with surgical diseases of the lungs.
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PMID:[Endobronchial laser therapy in complex preoperative preparation of patients with lung diseases]. 1071 Sep 18

Fibrosing mediastinitis is underdiagnosed because of the nonspecific character of the presenting symptoms. The endobronchial findings obtained via flexible bronchoscopy are not defined in the literature. We describe 3 cases of fibrosing mediastinitis, most likely caused by histoplasmosis. All 3 patients presented with hemoptysis and were found to have tracheobronchial concentric narrowing, severe hyperemia, and mucosal edema. The hyperemic blood vessels were treated with neodymium yttrium-aluminum-garnet (Nd:YAG) laser and argon plasma coagulation. We believe that recognition of specific endobronchial findings aids in prompt diagnosis of fibrosing mediastinitis.
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PMID:Endobronchial findings of fibrosing mediastinitis. 1463 20

A 50-year-old man with continuous hemosputa and large hematoma of left upper lobe contiguous to bilateral emphysematous bullous disease was admitted for surgery to stop hemorrhage and to resect left lung hematoma and multiple bullae. Bullectomy and neodymium yttrium aluminum garnet (Nd-YAG) laser irradiation to bullae of left upper lobe performed successfully with maximum preserved pulmonary function of it. Pathological examination, however, revealed anaplastic carcinoma inside bulla of S(1+2)c with minimal invasion into adhered parietal pleura (p 3). Left upper lobectomy was carried out with complete mediastinal lymph node dissection (ND 2 b). The final pathological diagnosis was large cell carcinoma of left S(1+2)c with the staging pT3N0M0 and stage II. The patient lives actively in daily life more than 7 years without any recurrence. Clinical analysis of Japanese 20 cases of lung carcinoma with initial signs of hemosputa and/or hemoptysis contiguous to emphysematous bullae elucidate following important facts. Hemosputa and hemoptysis play important role for early finding and diagnosis of lung cancer contiguous to bullous disease, especially in patients of early clinical stage with or without computed tomography (CT) exams and promise to better surgical prognosis and survivals as compared with non hemosputa ones.
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PMID:[Pulmonary large cell carcinoma contiguous to bullae with massive bullous hematoma and hemoptysis; with special reference to 20 cases of Japanese reports]. 1610 63


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