Home Medicine Nd:YAG Laser surgery of lung metastases
Article
Licensed
Unlicensed Requires Authentication

Nd:YAG Laser surgery of lung metastases

  • EMAIL logo
Published/Copyright: July 3, 2015
Become an author with De Gruyter Brill

Abstract:

Lung metastases occur during the course of the disease in many types of cancer. If the basic disorder is under control and there are no distant or mediastinal lymph node metastases, removal of the lung metastases can improve long-term survival. Lung metastases are non-anatomically removed from the healthy patient if they have not infiltrated any central bronchi or blood vessels. Nd:YAG lasers are particularly suitable for this. They cut the lung parenchyma and at the same time coagulate the resected surface. This means that large numbers of lung metastases can be removed with little bleeding. Modern Nd:YAG lasers (wavelength 1318 nm) are more efficient to use because the laser power is greater (80–100 W). This shortens the operation time and makes the resected surfaces more airtight. Consequently, resection zones on the surface need no longer to be sutured. The mortality and morbidity of the operations are low. Nd:YAG lasers are now indispensable in the surgical treatment of lung metastases.

Zusammenfassung:

Bei vielen Tumoren treten im Lauf der Erkrankung Lungenmetastasen auf. Ist das Grundleiden kontrolliert, d.h. liegen keine Fern- sowie mediastinale Lymphknotenmetastasen vor, kann durch eine Entfernung der Lungenmetastasen das Langzeitüberleben verbessert werden. Infiltrieren die Lungenmetastasen keine zentralen Bronchien oder Gefäße, so werden sie nichtanatomisch im Gesunden entfernt. Der Nd:YAG-Laser eignet sich dafür in besonderem Maße: er schneidet das Lungenparenchym und koaguliert gleichzeitig die Resektionsfläche. Dadurch können auch viele Lungenmetastasen blutungsarm entfernt werden. Die modernen Nd:YAG-Laser (Wellenlänge: 1318 nm) werden durch die höhere Laserleistung (80–100 W) effizienter eingesetzt. Dies verkürzt die Operationszeiten und erhöht die Luftdichtigkeit der Resektionsflächen. Oberflächliche Resektionszonen müssen nicht mehr übernäht werden. Die Mortalität und Morbidität der Operationen ist gering. Auf den Nd:YAG-Laser kann im Rahmen der Lungenmetastasenchirurgie nicht mehr verzichtet werden.


Corresponding author: Andreas Kirschbaum, Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, Baldingerstrasse, 35033 Marburg, Germany, e-mail:

References

[1] Vodicka J, Spidlen V, Simanek V, Safranek J, Skalicky T, Fichtl J, Mukensnabl P, Rousarova M. Surgical therapy of pulmonary metastases – 10-year results. Bratisl Lek Listy 2013;114(4): 218–24.10.4149/BLL_2013_045Search in Google Scholar

[2] Osei-Agyemang T, Ploenes T, Passlick B. Pulmonary metastasectomy: indication and technique. Zentralbl Chir 2012;137(3): 234–41.Search in Google Scholar

[3] Kawano D, Takeo S, Tsukamoto S, Katsura M, Masuyama E, Nakaji Y. Prediction of the prognosis and surgical indications for pulmonary metastectomy from colorectal carcinoma in patients with combined hepatic metastases. Lung Cancer 2012;75(2):209–12.10.1016/j.lungcan.2011.07.010Search in Google Scholar

[4] Tsukamoto S, Kinugasa Y, Yamaguchi T, Shiomi A. Survival after resection of liver and lung colorectal metastases in the era of modern multidisciplinary therapy. Int J Colorectal Dis 2014;29(1):81–7.10.1007/s00384-013-1752-3Search in Google Scholar

[5] Welter S, Cheufou D, Zahin M, Kampe S, Darwiche K, Weinreich G, Stamatis G. Short- and mid-term changes in lung function after bilateral pulmonary metastasectomy. Thorac Cardiovasc Surg 2014. doi: 10.1055/s-0034-1383828.10.1055/s-0034-1383828Search in Google Scholar

[6] Kirschbaum A, Braun S, Rexin P, Bartsch DK, Seyfer P. Comparison of local tissue damage: monopolar cutter versus Nd:YAG laser for lung parenchyma resection. An experimental study. Interact Cardiovasc Thorac Surg 2014;18(1):1–6.10.1093/icvts/ivt419Search in Google Scholar

[7] Stamatis G. Operative and interventional therapy of lung metastases. MMW Fortschr Med 2005;147(1–2):25–6, 28–9.Search in Google Scholar

[8] LoCicero 3rd J, Hartz RS, Frederiksen JW, Michaelis LL. New applications of the laser in pulmonary surgery: hemostasis and sealing of air leaks. Ann Thorac Surg 1985;40(6):546–50.10.1016/S0003-4975(10)60346-3Search in Google Scholar

[9] Moghissi K, Dench M, Goebells P. Experience in non-contact Nd YAG laser in pulmonary surgery. A pilot study. Eur J Cardiothorac Surg 1988;2(2):87–94.10.1016/S1010-7940(88)80004-6Search in Google Scholar

[10] Rolle A, Thetter O, Häussinger K, Hallfeldt KKJ, Schmölder A. Einsatz des Neodym-YAG-Lasers in der Thoraxchirurgie. Herz Gefäss Thorax Chir 1989;3:85–91.Search in Google Scholar

[11] Rolle A, Kozłowski M. Laser resection of lung parenchyma – a new technical and clinical approach. Rocz Akad Med Bialymst 2005;50:193–6.Search in Google Scholar

[12] Kirschbaum A, Ocker M, Bartsch DK, Quint K. Heat dissipation after nonanatomical lung resection using a laser is mainly due to emission to the environment: an experimental ex vivo study. Lasers Med Sci 2014;29(3):1037–42.10.1007/s10103-013-1460-9Search in Google Scholar PubMed PubMed Central

[13] Kirschbaum A, Rexin P, Pehl A, Bartsch D, Quint K. Laser resection of lung tissue: heat accumulation from adjacent laser application and how to cool it down. Thorac Cardiovasc Surg 2014;62(4):363–8.Search in Google Scholar

[14] Helfmann J. Thermal effects. In: Berlien H-P, Müller GJ, editors. Applied laser medicine. Berlin, Heidelberg and New York: Springer; 2003, p. 112–17.Search in Google Scholar

[15] Kirschbaum A, Palade E, Kayser G, Passlick B. Local effects of high-powered neodymium-doped yttrium aluminium garnet laser systems on the pulmonary parenchyma: an experimental study on the isolated perfused pig lung lobe. Interact Cardiovasc Thorac Surg 2012;15(2):191–3.10.1093/icvts/ivs140Search in Google Scholar PubMed PubMed Central

[16] Kirschbaum A, Steinfeldt T, Gockel A, Di Fazio P, Quint K, Bartsch DK. Airtightness of lung parenchyma without a closing suture after atypical resection using the Nd:YAG Laser LIMAX 120. Interact Cardiovasc Thorac Surg 2014;18(1):92–5.10.1093/icvts/ivt420Search in Google Scholar PubMed PubMed Central

[17] Rolle A, Pereszlenyi A, Koch R, Richard M, Baier B. Is surgery for multiple lung metastases reasonable? A total of 328 consecutive patients with multiple-laser metastasectomies with a new 1318-nm Nd:YAG laser. J Thorac Cardiovasc Surg 2006;131(6):1236–42.10.1016/j.jtcvs.2005.11.053Search in Google Scholar

[18] Rolle A, Koch R, Alpard SK, Zwischenberger JB. Lobe-sparing resection of multiple pulmonary metastases with a new 1318-nm Nd:YAG laser – first 100 patients. Ann Thorac Surg 2002;74(3):865–9.10.1016/S0003-4975(02)03805-5Search in Google Scholar

[19] Osei-Agyemang T, Palade E, Haderthauer J, Ploenes T, Yaneva V, Passlick B. Pulmonary metastasectomy: an analysis of technical and oncological outcomes in 301 patients with a focus on laser resection. Zentralbl Chir 2013;138(Suppl 1):S45–51.10.1055/s-0033-1350873Search in Google Scholar PubMed

Received: 2015-5-11
Revised: 2015-5-26
Accepted: 2015-5-27
Published Online: 2015-7-3
Published in Print: 2015-8-1

©2015 by De Gruyter

Downloaded on 1.4.2026 from https://www.degruyterbrill.com/document/doi/10.1515/plm-2015-0018/html
Scroll to top button