Chest & Lung Specialist

Lung Cancer

• Lung cancer is a common and deadly disease. When diagnosed in early stages, patients can benefit from surgery. Cancer affected part of the lung or in certain cases; entire lung is removed surgically. Few lung tumours are non-cancerous and their surgery gives very satisfactory long term results.

Lung Infections

• Some lung infections are difficult to treat. Conditions like lung abscess, bronchiectasis, multi-drug resistant tuberculosis (MDR TB) and chronic empyema are difficult to treat without surgery. Surgical removal of infected tissue greatly reduces amount of infection in body. So, antibiotics have better chance to treat these stubborn infections.  

Coughing of Blood

• Coughing out of blood from lungs is called hemoptysis. Common causes of hemoptysis are various lung infections and lung cancer. In some patients, tuberculosis causes lung destruction and cavity formation, from which bleeding occurs. Severe hemoptysis not controlled by medicines needs surgery (sometimes an emergency, lifesaving surgery) to remove diseased part of lung from where bleeding occurs.

COPD

• COPD (chronic obstructive pulmonary disease) patients have increased resistance to flow of air in small air passages of lung in addition to destruction of lung tissue. Major causes are air pollution (vehicular exhaust, indoor smoke due to wood or coal burning in kitchen, exposure to toxic gases or fumes in work places etc.) and most importantly – smoking (primary or passive / second hand).
• Certain complications occurring in advanced COPD like pneumothorax or lung collapse or bronchopleural fistula may need surgical treatment.

Lung Bulla

• Bullous Lung Disease is a condition where there is abnormal, bubble like air space (sometimes multiple) on surface of lung. Bulla can rupture and cause collapse of lung tissue – a condition called pneumothorax. Some bulla become very large and compress normal lung tissue, causing difficulty in breathing. These conditions require surgery in form of putting in a tube to drain air (ICD or intercostal drainage) or surgical removal of bulla compressing the normal lung.

Lung Injuries

• Lung Injuries can be blunt (as in vehicular accidents, fall from height, assault etc.) or penetrating (as in stabbing). Blunt lung injuries are usually accompanied by multiple other injuries like rib fractures, long bone fractures, abdominal injuries etc. These patients tend to be very serious. Timely recognition and treatment of these injuries can be lifesaving.

Resistant Tuberculosis

• Tuberculosis (TB) is primarily treated by anti TB drugs. In a small proportion of cases, TB bacteria become resistant to these drugs – resulting in multi-drug resistant – MDR TB or extreme drug resistant XDR TB. Some patients are unable to tolerate anti TB drugs due to severe side effects. Some patients develop major complications from TB like bleeding from lungs (hemoptysis), collapse of lung with air leakage (bronchopleural fistula), pus in chest cavity (empyema) etc. In such patients surgery is done to remove the diseased portion of lung or to treat other complications. Surgery can be lifesaving in such cases.

Lung Defects by Birth

• Lung Defects by Birth – some children are born with rare conditions where in there are developmental 9by birth) abnormalities in lungs or its air passages. Abnormalities like Congenital Cystic Adenomatoid Malformation (CCAM), Congenital Lobar Emphysema, Congenital Tracheo-Oesophageal fistula (TOF) become apparent immediately after birth or in early childhood. Whereas abnormalities like Intralobar Sequestration, Extralobar Sequestration or Bronchogenic Cysts become apparent in adult life. All of these conditions are treatable by timely diagnosis and surgery.

Pleural Infections / Empyema

• Diseases of chest wall and pleura (space between lung and chest wall). These diseases are largely secondary to advanced lung infection, neglected pneumonia or major chest injuries. There is collection of pus in pleura, development of thick fibrous tissue over lungs and inner chest wall and resulting compression of lung. These conditions are treatable by surgeries like intercostal drainage, decortication, thoracoplasty etc.

Mediastinal Tumours

• Mediastinum is the space in chest, in front of heart and behind the heart. Tumours (growths) or infections can happen within the mediastinum. In anterior mediastinum (area in front of heart) – tumours of thymus gland (thymomas)  are common,  while in posterior mediastinum (area behind the heart), tumours arising from nerve tissues (neurogenic tumours) are common. These condition often require surgeries for diagnosis and treatment.

Fractures / Tumours of Ribs and Sternum

• Diseases of Ribs and Sternum (bone in front of chest, also called breast bone) – In cases of severe accidents, ribs and/or sternum develop multiple fractures. This results in chest wall instability and difficulty in breathing. In such rare cases surgical fixation of these fractures is needed.
• Rarely ribs or sternum are site of infection (usually tuberculosis) and this will need removal of infected bone by surgery.
• Tumours of ribs are rare and tumours of sternum are even rarer. Chondroma is a type of tumour usually seen in ribs. These tumours require surgical removal and reconstruction of defect.