Patients with endobronchial renal cell carcinoma (RCC) are at high risk for significant hemoptysis. We evaluated the palliative efficacy and risks of Nd:YAG laser phototherapy in treating such patients, and observed their survival. The medical records of all patients (n = 13) with endobronchial RCC who underwent Nd:YAG laser phototherapy from 1990 to 2003 at our institution were reviewed. Twenty-three laser procedures were performed, resulting in a 98% mean reduction in endobronchial obstruction by proximal lesions, and a 43% mean reduction in obstruction by distal lesions. All patients on mechanical ventilation (n = 2) were successfully weaned within 24 hours after laser therapy. The overall complication rate was 0.87 per procedure. Hemorrhage accounted for 60% of total complications (mean estimated blood loss, 107 ± 135.9 mL). Mean survival from date of first laser intervention was 8.8 ± 9.3 months. Patients with RCC who demonstrate respiratory symptoms ought to be promptly evaluated for an endobronchial RCC component. Nd:YAG laser phototherapy can be highly effective as a palliative procedure in patients with endobronchial RCC, despite the significant hemorrhage risk. Because potentially life-threatening hemorrhage remains the single most serious complication during bronchoscopy, these procedures ought to be performed in a tertiary referral center by bronchoscopy teams with adequate experience and expertise.
- Nd:YAG laser
- Renal cell carcinoma
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine