Cardiothoracic Surgery in Non Malignant Situations Flashcards
What is lung volume reduction surgery (LVRS) and in which conditions is it used?
Lung volume reduction surgery (LVRS) involves the removal of damaged, emphysematous lung tissue to improve airflow and reduce the work of breathing. It is most commonly used in patients with severe emphysema (a form of chronic obstructive pulmonary disease (COPD)) to enhance lung function and reduce symptoms like breathlessness.
How does lung transplantation benefit patients with non-malignant lung disease?
Lung transplantation is indicated for patients with advanced restrictive lung diseases (e.g., idiopathic pulmonary fibrosis, cystic fibrosis) or severe chronic obstructive pulmonary disease (COPD). It offers a potential cure for respiratory failure by replacing the damaged lungs with healthy donor lungs, improving both survival and quality of life in selected patients.
What is the role of surgery in managing a pneumothorax?
Surgical intervention for pneumothorax (collapsed lung) is considered when:
The pneumothorax is large or recurrent.
It causes significant respiratory distress.
It doesn’t resolve with conservative management (e.g., chest tube insertion).
Video-assisted thoracoscopic surgery (VATS) or thoracotomy may be performed to remove the bullae (air-filled spaces) causing the pneumothorax and prevent future episodes.
What is pleurodesis and when is it indicated?
Pleurodesis is a surgical procedure that involves the introduction of a sclerosing agent (e.g., talc) into the pleural space to promote adhesion of the pleura to prevent the recurrence of pneumothorax or pleural effusion. It is indicated in cases where these conditions are recurrent or persistent despite other treatments.
How is bronchial artery embolization used in non-malignant lung disease?
Bronchial artery embolization (BAE) is used to control hemoptysis (coughing up blood) in patients with bronchiectasis, tuberculosis, or lung abscesses. The procedure involves blocking the blood vessels that are causing the bleeding, providing a life-saving intervention in patients who have severe, recurrent hemoptysis.
What is the role of surgery in treating lung abscesses?
Lung abscesses may require surgery if they do not respond to antibiotics or drainage procedures. Surgical options include:
Drainage of the abscess through a chest tube or minimally invasive techniques like VATS.
In severe cases, a lobectomy (removal of part of the lung) may be necessary if the abscess is large or causing significant symptoms.
When is a thoracotomy necessary in non-malignant lung disease?
Thoracotomy is a more invasive surgical procedure that involves opening the chest cavity. It may be necessary in the management of conditions like:
Severe pneumonia with complications such as lung abscess or empyema.
Recurrent pneumothorax that doesn’t resolve with other methods.
Intractable hemoptysis when bronchial artery embolization or other techniques fail.
What is the role of surgery in non-malignant lung disease?
Surgery plays a significant role in the management of certain non-malignant lung diseases, including:
Lung volume reduction surgery: In conditions like emphysema (a form of COPD), this surgery removes damaged lung tissue to improve airflow and overall lung function.
Lung transplantation: Considered for patients with end-stage restrictive lung diseases (e.g., idiopathic pulmonary fibrosis, cystic fibrosis) or chronic obstructive pulmonary disease (COPD) who are no longer candidates for medical management.
Thoracotomy or video-assisted thoracoscopic surgery (VATS): Used to treat complications like pneumothorax (collapsed lung), empyema, or lung abscesses.
Pleurodesis: A procedure to prevent recurrent pneumothorax or pleural effusion by causing the pleura to stick together.
Bronchial artery embolization: Performed for patients with hemoptysis (coughing up blood) due to non-malignant causes like bronchiectasis.
