gms | German Medical Science

16. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie

Deutsche Gesellschaft für Thoraxchirurgie

04.10. - 06.10.2007, Konstanz

Limited resection of stage I primary lung cancer by 1318-nm Nd-YAG laser in high-risk geriatric patients

Meeting Abstract

  • Stefan B. Watzka - Otto Wagner Hospital, Thoraxchirurgie, Wien, Österreich
  • Wilfried Grossmann - University of Vienna, Institute for Scientific Computing, Wien, Österreich
  • Peter N. Wurnig - Otto Wagner Hospital, Thoraxchirurgie, Wien, Österreich
  • Franz Lax - Otto Wagner Hospital, Thoraxchirurgie, Wien, Österreich
  • Michael Rolf Müller - Otto Wagner Hospital, Thoraxchirurgie, Wien, Österreich
  • Peter H. Hollaus - Otto Wagner Hospital, Thoraxchirurgie, Wien, Österreich

Deutsche Gesellschaft für Thoraxchirurgie. 16. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie. Konstanz, 04.-06.10.2007. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc07dgtV17

DOI: 10.3205/07dgt48, URN: urn:nbn:de:0183-07dgt488

Veröffentlicht: 22. März 2010

© 2010 Watzka et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Recent case-matched studies demonstrate that stage I non-small cell lung cancer (NSCLC) in functionally inoperable patients can be treated by limited resection approaches without compromising the oncological result. The recently introduced 1318-nm Nd-YAG laser enables the highly selective and parenchyma-saving excision of pulmonary lesions, and was thus originally designed for the removal of multiple lung metastases and more central lesions. In this prospective study, we are evaluating the mid-term results after local resection of stage I primary NSCLC by laser knife in high-risk geriatric patients with significant co-morbidities and a predicted postoperative FEV1 (ppoFEV1) less than 40%.

Material and Methods: Between 2001 and 2005, 15 high-risk geriatric patients underwent local resection of stage I NSCLC by 1318-nm Nd-YAG laser. We assessed their postoperative course, tumor recurrence, and survival by statistical means.

Results: Postoperative mortality was zero. Three patients (20%) had minor surgical complications in the postoperative period (persistent air leak, delayed wound healing). The postoperative respiratory function was unchanged as compared to the pre-operative value. The median follow-up was 13.7 months (range 4–25 months). Recurrence rates (6.6%) and actuarial 2-year survival (68%) were comparable to standard lobectomy results, as reported in the literature. None of the four deaths observed during the follow-up period was cancer-related (cardiorespiratory disease).

Conclusion: The 1318-nm Nd-YAG laser enables the resection of stage I NSCLC in geriatric high-risk patients under complete preservation of respiratory function, but without jeopardizing the oncological outcome.