Pulmonary Laser Metastasectomy by 1318-nm Neodymium-Doped Yttrium-Aluminum Garnet Laser: A Retrospective Study About Laser Metastasectomy of the Lung

Abstract

Our results show that laser resection of lung metastases can achieve good result, in terms of radical resection and survival, as conventional surgical metastasectomy. The great advantage is the possibility of limiting the damage to the lung. Stapler resection of a high number of metastases would mutilate the lung.

Local Effects of a 1940 nm Thulium-Doped Fiber Laser and a 1470 nm Diode Laser on the Pulmonary Parenchyma: An Experimental Study in a Pig Model

“…According to many authors, there is no need to secure the lung parenchyma with clips or other sealants in the case of removing single small lesions with a laser [ 40 ]. Moreover, laser-assisted surgery seems to be a safe and effective alternative to lobectomy in cases of large or central metastases where the SWR is technically impossible and mechanical resection can cause deformation and distortion of the lung parenchyma [ 17 , 18 , 19 , 41 , 42 , 43 ]. Studies have found that the Nd:YAG laser (1318 nm) is a tool that cuts, coagulates, seals, and stops bleeding as well as sterilizing wound edges in an area of up to 5 mm, which may improve the oncological radicality of the resection [ 17 , 44 , 45 ].…”

“…Studies have found that the Nd:YAG laser (1318 nm) is a tool that cuts, coagulates, seals, and stops bleeding as well as sterilizing wound edges in an area of up to 5 mm, which may improve the oncological radicality of the resection [ 17 , 44 , 45 ]. This technique has been positively assessed in terms of its facility, the low percentage of perioperative complications, completeness of resection, and oncological results [ 19 , 41 , 44 , 46 ]. In the retrospective study by Stefani et al (2019), laser-assisted resection of large and centrally located lung masses resulted in a better immediate surgical outcomes and shorter hospital stay, while the recurrence rate and survival times did not differ when compared with lobectomy [ 40 ].…”

“…Lasers can be used to excise more metastases while achieving an equivalent long-term survival rate and enabling re-operations when necessary [ 18 ]. Some previous studies have even demonstrated the superiority of laser ablation compared with standard surgical procedures in terms of the success of radical resection, patient survival rates, the simplicity of video-guided laser procedures during minithoracotomy, and the possibility of intra-operative lung palpation [ 19 , 20 ]. In summary, laser use in lung surgery is highly promising due to the fact of its prevention of hemorrhaging during and post-surgery, its preservation of healthy lung tissue as well as the possibility it provides of removing cavernous lesions in sites that were previously inaccessible surgically [ 21 ].…”

Porcine skin damage thresholds and histological damage characteristics from 1319-nm laser radiation

“…One typical medical application is in the removal of tumor tissues using the 1318-nm high-power laser. [7][8][9][10][11] Other potential applications include nonablative skin rejuvenation treatment and neural stimulation. 12,13 Considering the increasing use of NIR lasers in the wavelength range of 1300 to 1400 nm, [7][8][9][10][11][12][13] it is important that they are used safely and that their use is not unnecessarily restricted.…”

Pulmonary metastasectomy and laser-assisted resection

“…S o m e i n v e s t i g a t o r s h a v e e m p l o y e d 1 , 3 1 8 -n m neodymium-doped yttrium-aluminum garnet laser for resection of lung metastases. They demonstrated that with the use of this technique achieved good results, in terms of radical resection and survival, as conventional surgical metastasectomy (22).…”