TREATING BULLOUS LUNG-DISEASE WITH HOLMIUM-YAG LASER IN CONJUNCTION WITH FIBRIN GLUE AND DEXON(TM) MESH

Background and Objective: Holmium YAG (Ho:YAG) laser energy is highly absorbed by water, and this property is useful to uniformly ablate pul monary bullae. The current study summarizes the data of a 39-month fol low-up of patients treated for bullae with a Ho:YAG laser. Study Desig n/Materials and Methods: We used a Ho:YAG; laser from August 1994 to A pril 1997 to treat small pulmonary bullae in 50 patients. For the firs t five patients, Ho:YAG laser ablation was followed by resection for h istological assessment. In the next six patients, fibrin glue was appl ied following bullae ablation with the Ho:YAG laser. In all subsequent patients, a DEXON(TM) (polyglycolic acid) mesh patch soaked in fibrin glue was employed after ablation. Results: From the six patients rece iving only the fibrin glue following laser ablation, delayed pneumotho rax developed in one patient. In the subsequent 39 patients patched wi th DEXON(TM) mesh soaked in fibrin glue, none encountered delayed pneu mothorax. Conclusion: The combined use of fibrin glue and Dexon(TM) me sh with the Ho:YAG laser may be an effective technique for treating bu llous lung disease. (C) 1998 Wiley-Liss, Inc.