ABSTRACT
AIMS: Analysing the results of extensive parenchymal resections in 110 patients we want to demonstrate the safe usage and the superiority of the second Nd: YAG laser wavelength (1318 nm) which shows significantly better lung tissue determinants. METHODS: Between 3/96 and 11/97, 110 patients (66 men and 44 women, mean age 60 years) were integrated prospectively in three groups and underwent pulmonary surgery with the Nd: YAG laser of the 1318 nm wavelength. 78 patients had suspected lung metastases of known primary malignancies (group 1); 20 patients with poor lung function had peripheral T1 or T2 lung primaries (group 2) and 12 patients had multiple pulmonary nodules but unknown malignancies (group 3). RESULTS: In group 1 we resected 353 nodules or 4.6 nodules per patient, between 5 and 60 nm. Although 41% of all lesions were deep-seated and only 28% solitary, it was in 97.5% possible to perform precision resections. In two patients (2.5%) lobectomy was necessary which demonstrates a drastic decrease of the lobectomy rate--reported between 20 and 30% in the literature. There was no mortality in all groups, and only two complications were treated conservatively. DISCUSSION: The technical improvements in this special laser (1318 nm) allow extensive parenchymal resections and should make the long-discussed advantages of lasers in open lung surgery applicable to a broad clinical usage.
