This new 1318-nm Nd:YAG laser facilitates complete resection of multiple bilateral centrally located metastases and thus is lobe sparing. Resection of 20 or more metastases is reasonable because long-term survival was significantly better than that observed with incomplete resection.

BLTX with intraoperative and postoperatively prolonged ECMO support provides excellent initial organ function due to optimal controlled reperfusion and non-aggressive ventilation. This results in improved outcome even in advanced forms of PH.

Coverage of the bronchial stump contributes to a low incidence of PBSF. In view of the fact, that this serious complication was completely avoided in the pericardial flap group (used in patients with expected higher risk for PBSF), this particular technique seems to offer the best results.

Background and Objectives: Advantages of a new 1,318 nm Nd:YAG laser based on multiple lung metastasectomies are shown. Study Design/Materials and Methods: Ninety-three percent of 328 patients with metastases (8/patient, range 1-124) had precision laser resections (lobectomy-rate reduced to 7%); this laser delivers 20 kW/cm 2 1,318 nm power densities with 400 mm fibers, and a focussing handpiece. Absorption in water is tenfold higher. Results and Conclusions: Between 1/1996 and 12/2003 in 328 patients (164 males/females, 61 years) 3,267 nodules were removed. Pathologic examination revealed 2,546 metastases (range 3-80 mm) from kidney (n ¼ 112), colorectal (n ¼ 91), and breast cancers (n ¼ 35). In 85% of patients where the complete resection was achieved the 5-year survival was 41%. For remaining 15% (incomplete resection) the 5-year survival was 7%. Five-year survival for patients with 10 (and more) metastases was 28%, for patients with 20 (and more) was 26%. No 30-day mortality was observed. Conclusion: This new laser system facilitates any kind of parenchymal lung resection in lobe-sparing manner and in case of complete resection improves significantly the survival.

A rare case of a giant pulmonary chondromatous hamartoma (15 cm, 1350 g) resected by a new laser system (Nd:YAG, 1318 nm, 40 W) is presented. The laser management of a hamartoma resection--the largest reported to date in the literature--is presented here.