Two Step Emergency Treatment of Malignant Tracheal Stenoses

Neodym Yag laser treatment is widely used in urology, neurology, gastroenterology and pulmonology. In Pulmonology, laser therapy is usually limited to endobronchial processes when the perfusion of the afflicted lung is preserved, but there are essentially no restrictions to its use in cases of endotracheal obstructions not amenable to surgery or radiotherapy (1). Since these patients are frequently in a life threatening state with poor lung function and severe hypoxia the safe performance of the procedure usually requires general anesthesia with jet ventilation and the use of a rigid bronchoscope (2). In very rare cases the functional reserves of the patients are limited to such an extent that general anesthesia may be impossible. We would like to report the case histories of two patients whose treatment was particularly difficult due to severe restrictions of lung function testing.