Treatment of thyroid cancers invading trachea and bronchi with Nd-YAG laser

Surgery is the common therapy for advanced thyroid cancers with local invasions to trachea. There are many patients suffering from postoperative relapses or according to their poor general conditions are not eligible for an operation. Regardless of different types of thyroid cancers, utilization of Nd-YAG laser as an effective method leads to evacuation of tracheal invasion of tumor, removal of stenosis and improvement of respiratory condition. An uncontrolled clinical trial was performed in patients who were seeking medical advice in Masih Daneshvari hospital from 1997 to 2001. All patients had local invasions of tumor, tracheal stenosis and symptoms of obstructive respiratory discomfort relevant to stenosis. After bronchoscopic evaluations all patients underwent Nd-YAG laser therapy through photocoagulation and photoevaporation processes under local anesthesia. The eleven patients in the survey (5 men and 6 women) had mean age of 49.7 for men and 55.5 for women. Patients underwent laser therapy for 8 to 25 sessions that lasted 6 months up to 3 years. All patients after finishing their own specific therapy periods were discharged from hospital with a dramatic change in their health condition and utter removal of their obstructive symptoms. No complication was detected during one-year follow up period. This trial reveals that Nd -YAG laser treatment provides an excellent method of resuscitating patients with life threatening tracheal obstruction and enables symptomatic treatment. Besides achieving good results and avoiding an operation and its probable complications, Nd -YAG laser can be introduced as a practical and safe tool for improving the health condition and quality of life during the rest of life in such patients.