These include bronchiectasis, aspergillomas and sequelae of TB, lung cysts, spontaneous pneumothorax and surgery for multi drug resistant TB. Fortis surgeons have a large experience in treating these conditions with open or minimal access surgery (VATS or Robotic)
Bronchiectasis is a condition in which damage to the airways causes them to widen and become flabby and scarred. The airways are tubes that carry air in and out of the lungs.Bronchiectasis usually is the result of an infection or other condition that injures the walls of the airways and prevents the airways from clearing mucus. The initial lung damage that leads to bronchiectasis often begins in childhood.
However, symptoms may not occur until months or even years after you start having repeated lung infections.When mucus can’t be cleared, it builds up and creates an environment in which bacteria can grow. This leads to repeated, serious lung infections. Each infection causes more damage to the airways.
Symptoms include a daily cough that occurs over months or years and daily production of large amounts of phlegm and sometimes, blood in the sputum. Severe bleeding can occur. Bronchiectasis can affect just one section of one of your lungs or many sections of both lungs.
In cases where bronchiectasis occurs in a single section of the lung, the damaged areas can be removed with surgery with excellent results. Ask your treating doctor to refer you for a surgical opinion.
- Aspergilloma: An aspergilloma is a fungus ball which exists in an organ such as the lung. By definition, it is caused by fungi of the genus Aspergillus. The most common organ affected by aspergilloma is the lung. Aspergilloma mainly affects people with previous underlying cavitary lung disease such as tuberculosis, sarcoidosis, bronchiectasis, cystic fibrosis and people who have a weak immune system (systemic immunodeficiency).
In some cases, aspergillomas invade into a blood vessel which can result in bleeding. Thus, the most common symptom of associated with aspergilloma is coughing up blood (hemoptysis). This may result in life-threatening hemorrhage.
In cases complicated by severe hemoptysis or other associated conditions such as pleural infection or rupture into chest cavity called pneumothorax, surgery may be required to remove the aspergilloma and the surrounding lung tissue to stop the bleeding.
- Surgical treatment for multidrug-resistant and extensive drug-resistant tuberculosis
Multidrug-resistant (MDR) and extensive drug-resistant (XDR) tuberculosis (TB) are still significant health problems in India. Surgical resection is a good adjunctive intervention for patients with MDR or XDR TB. Early pulmonary surgery combined with chemotherapy has high cure rates with acceptable complications and preservation of the lung parenchyma in MDR TB and XDR TB. Whenever possible, a surgeon’s opinion should be sought.
A pulmonary sequestration (bronchopulmonary sequestration or cystic lung lesion), is a condition where a piece of tissue that ultimately develops into a functionless lung tissue is not attached to the pulmonary arterial blood supply, as is the case in normally developing lung. This sequestered tissue is not connected to the normal airway architecture.
This tissue receives its arterial blood supply from the systemic circulation which can be easily detected by a CT or MR angiogram.Treatment is early surgery. Failure to have a pulmonary sequestration removed can lead to
- Bleeding that can be fatal.
- The creation of a left-right shunt, where blood flows in a shortcut through the feed off the aorta.
- Chronic recurrent infection. Diseases such as bronchiectasis, tuberculosis, aspergillosis, bronchial carcinoid and bronchogenic squamous cell carcinoma.