Over the past 25 years the development of lasers has progressed from their experimental use in the research laboratory to their application in medicine in a variety of ways. Three medical laser systems are currently available for direct tissue ablation: the carbon dioxide laser, the argon laser, and the neodymium-yttrium aluminum garnet (Nd-YAG) laser. Because of various characteristics of their beams, these lasers produce different therapeutic effects on tissue. Candidates for the Nd-YAG laser are patients who are symptomatic of endobronchial obstruction. The bulk of these patients are suffering from inoperable bronchogenic carcinoma and have failed to be helped by conventional therapy and/or require immediate relief. We describe a 64-year-old man with symptoms of upper-airway obstruction from a recurrent bronchogenic carcinoma. This patient benefited greatly from Nd-YAG laser therapy; following two photoresections 1 month apart, he remained symptom free for 5 months, when he died from tumor metastasis to the liver. Photoresection with the Nd-YAG laser may become a valuable therapeutic tool for relieving airway obstruction in the inoperable patient.
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