Active smoking, COPD and arterial hypertension are independent prognostic factors for complications following Nd:YAG laser resection of central lung cancer

Introduction: Major aim of this study was to investigate complication rate and identify clinical risk factors for complications following Nd:YAG laser resection in patients with advanced lung cancer. Patients and methods: We evaluated medical and bronchoscopy charts of 512 patient who underwent Nd:YAG laser resection as a part of multimodality treatment of lung cancer. Complications after laser resection were defined as: severe hypoxemia, global respiratory failure, arrhythmia requiring treatment, haemoptysis, pneumothorax, pneumomediastinum, pulmonary edema, trachea-esophageal fistulae and death. Risk factors were defined as: acute myocardial infarction within 6 months before treatment, hypertension, chronic arrhythmia, chronic obstructive pulmonary disease (COPD), stabilized cardiomyopathy, previous external beam radiotherapy, previous chemotherapy and previous interventional pulmonology treatment. Results: Overall complication rate was 8.4%. Statistically significant risk factors were: age (p=0.001), current smoking status (p=0.012), arterial hypertension (p Conclusion: Closer monitoring of patients with identified risk factors is advisable prior and immediately after laser resection. In order to avoid or minimize complications special attention should be directed towards patients who are current smokers (over 60 pack years), over 60 years of age, with arterial hypertension or COPD.