Bronchiectasis

Bronchiectasis is the destruction and widening of the larger airways. It is caused by severe or recurring infections as well as scarring or obstruction (tumor or foreign body) of the large airways. Cystic fibrosis can also lead to bronchiectasis. Symptoms include:

  • Wheezing
  • Shortness of breath
  • Fatigue
  • Coughing and/or chronic cough
  • Weight loss
  • Bad breath
  • Clubbing of fingers

Treatment options include:

  • Medication, including antibiotics
  • Drainage of the lungs everyday to help control the buildup of secretions and blockage
  • Breathing therapies
  • Thoracic surgery (for repeated infections or significant bleeding from a portion of the lung)

Interstitial Lung Disease

Interstitial lung disease is a group of disorders that causes scarring on the lungs. For most people this is a gradual process that interferes with breathing over time. However, for some, this scarring may occur quickly and without warning. Some of the causes include:

  • Infections
  • Exposure to environmental toxins
  • Exposure to radiation
  • Connective tissue disorders like lupus, arthritis and myositis

Symptoms may vary depending on the cause; however, most patients report a dry cough and a feeling of breathlessness during exercise. Although surgery may be used to diagnose the particular type of interstitial lung disease, treatment is based on medication and breathing therapies. If these treatments are ineffective, a lung transplant may be recommended.

Pulmonary Nodules

These small areas of abnormal tissue in the lungs are very common, usually have no symptoms, and are often benign. A thoracic surgeon will want to determine if the pulmonary nodule is malignant or benign.

For many patients with pulmonary nodules, surgical intervention is not needed. Occasionally, further tests are needed to make sure the nodule does not grow. Some patients may need a biopsy either because the nodule appears suspicious or because there has been documented growth of the nodule over a period of time. Your thoracic surgeon will create an individualized treatment plan based on this information.

Emphysema

Emphysema is a form of lung disease that limits the amount of air you can breathe out. Your lungs are two large sacs filled with smaller sacs. These smaller sacs are attached to small airways. Emphysema causes the destruction of these smaller sacs. Patients with emphysema are usually smokers. However, some people with emphysema have a protein deficiency that puts them at risk for developing this disease.

Symptoms include:

  • Shortness of breath
  • Wheezing
  • Coughing
  • Fatigue
  • Weight loss
  • Tightness of the chest

The primary treatment for emphysema is medication and lifestyle modification programs, including a smoking cessation program. Stopping smoking is the most important part of emphysema treatment, as it is the only way to stop the damage from occurring to the lungs.

If the emphysema continues to progress, your doctors may recommend surgery called lung volume reduction surgery, or LVRS. This procedure can help those patients with end-stage emphysema. There are two approaches to LVRS:

  • Minimally-invasive thoracoscopy on each side: Using an endoscope and small incisions in the chest, a thoracic surgeon removes the top half or top third of the damaged lobe. The lung will now have less damaged tissue and will be able to breathe more efficiently.
  • Median sternotomy: The breastbone is divided to gain access to both lungs through one incision. LVRS is then performed as above.

Collapsed Lung

A collapsed lung occurs when air fills around the lung, making it difficult for the lung to inflate and for the patient to breathe. The main cause is an air blister that develops on the surface of the lung, causing it to burst and leak air into the space around the lungs.

Symptoms include:

  • Tightness in chest
  • Difficulty breathing
  • Racing heartbeat
  • Sharp pain in the chest

Using small incisions, a thoracic surgeon will insert a specially lighted microscope and tiny instruments to remove the blister. In order to ensure the lungs don't collapse again, an additional procedure called a mechanical pleurodesis is performed. Using a piece of gauze, the surgeon strokes the lung tissue so that it sticks to the chest wall, forming a seal that prevents air leaking again.