To analyze the safety and efficacy of transbronchoscopic superpulse Nd: YAG laser (model: Ligenesis-MY100C) ablation in the treatment of central airway stenosis.

From January 2022 to September 2024, transbronchoscopic hyperpulse Nd︰YAG laser was performed by the Department of Respiratory and Critical Care Medicine of our hospital. Clinical data of 45 patients treated with Ligenesis-MY100C were analyzed, including general clinical data, laser treatment and post-treatment follow-up.

Among the 45 patients with central airway stenosis, 32 cases (74.42%) were pulmonary malignant tumors, including 21 cases (65.62%) of lung squamous cell carcinoma, 7 cases (21.88%) of lung adenocarcinoma, 3 cases (9.38%) of small cell lung cancer, and 1 case of adenoid cystic carcinoma (3.12%), indicating that the rates of central airway stenosis caused by squamous cell carcinoma and adenocarcinoma were similar. There were 13 cases of benign lung lesions (25.58%), including 7 cases of endotracheal tuberculosis (53.85%), 5 cases of hamartoma (38.46%) and 1 case of tracheal ossification (7.69%). After bronchoscopic superpulse Nd︰YAG laser ablation, no burns, moderate to massive bleeding, or uncontrollable arrhythmia were found during the operation. No asphyxia, arrhythmia, frequent cough, or pain occurred after the operation. After 3 months of follow-up, no patients with benign airway stenosis had airway stenosis again, and about 10 patients with malignant airway stenosis had airway stenosis again due to tumor regrowth. Oxygen is cut off during the operation, and the smoke produced by ablation can be drawn by continuous negative pressure to clear the airway for a clear view. The KPS score of the patients after laser ablation was significantly improved, and the difference was statistically significant (P<0.05).

Transbronchoscopic superpulse Nd︰YAG laser ablation can be safely and widely used for benign and malignant central airway stenosis as long as the operation skills are mastered, and benign airway stenosis has more benefits. For patients with malignant airway stenosis, the primary lesion should be controlled with effective systemic therapy.