Chest
Volume 94, Issue 5, November 1988, Pages 1086-1088
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Selected Reports
Long-term Survival after Endobronchial Fire during Treatment of Severe Malignant Airway Obstruction with the Nd:YAG Laser

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We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fire occurred. The patient survived without complications of the fire and was followed-up until death over 22 months after the fire. The events leading to the fire are presented and recommendations provided to prevent similar occurrences.

Section snippets

CASE REPORT

A 65-year-old woman with squamous cell carcinoma (left upper lobe resection in June, 1985) was admitted to another hospital in November, 1985 with dyspnea and chest pain. Physical examination revealed pulse rate of 88/min; respirations, 24/min; blood pressure, 164/94 mm Hg; inspiratory and expiratory rhonchi and diffuse wheezes. The chest x-ray film showed elevation of the left hemidiaphragm with well expanded left lower lobe. Arterial blood gas determinations showed: pH, 7.37; PO2, 49; PCO2,

DISCUSSION

Laser phototherapy has been shown to be effective with acceptable risks in the management of malignant and benign obstructing airway lesions.1 The concomitant use of radiation therapy after LPT for malignant lesions improves the quality of life and survival, which may exceed one year.34 At initial treatment, our patient had a Karnofsky score of 10 percent, indicating an extremely poor prognosis with a high likelihood of early mortality. As a result of the endobronchial fire, there was initial

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