Monday, June 11, 2012
Online Communications and
Social Media Coordinator
Please Note: The content found
on this Blog is for informational
purposes only. It should not be
a substitute for professional
medical advice, diagnosis, or
treatment. If you have any
questions regarding a personal
medical condition, you should
always ask your physician.
Never ignore medical advice or
postpone care due to something
you have read on our site.
All Blog posts are reviewed and
approved by the physician cited
in the article, as well as by
Steven J. Davidson, MD, Chief
Medical Informatics Officer
When I conduct research for the articles I write for Maimonides Medical Center, I often come across a lot of seemingly contradicting concepts. I’ve learned to take things with a grain of salt such as the claims of “chocolate is good for you!” or “why exercise may make you fat.” However, I did a double take when I read that eliminating a part of the lung can actually help people with severe emphysema breathe better. It didn’t make sense. How can removing lung tissue increase a patient’s lung function? Because I found this concept so intriguing, I decided to do some ‘extra research’ and sat down with Dr. Loren Harris, Director of Thoracic Surgery.
Dr. Harris explained to me that people with severe emphysema often have difficulty breathing when the lung begins to deteriorate from the disease. Pressure in the alveoli (tiny air pockets in the lungs) increases and the alveoli burst. When the alveoli rupture, they form thin-walled air-sacs which trap air. Called bullae, these sacs expand and do not deflate – restricting how deep of a breath a person can take. “Due to the expansive nature of these destroyed areas, the still functioning portions of the lung are compressed and breathing is inhibited,” notes Dr. Harris. The formation of bullae compresses the surrounding lung and can cause it to collapse.
What’s so interesting about the treatment for this severe type of emphseyma is that a surgeon actually removes part of the lung to help with breathing. It seems a bit contradictory – removing lung to increase lung function – but it’s beneficial for people with bullous emphysema. “Even though physicians may remove up to 30% of the lung, breathing actually improves as the restrictive aspects of the disease are removed,” explains Dr. Harris.
Depending on the location of the bullae, the condition of the patient, and the preferred surgical approach of the thoracic surgeon, there are three different surgical approaches available when conducting lung reconstructive surgery. The main surgical options include:
- Thoracoscopy: This minimally invasive approach uses only 3 to 5 small incisions on both sides of the chest and between the ribs. A tiny camera called a videoscope is then inserted through one of the small incisions, so the doctor can view the damaged lung.
- Thoracotomy: An incision between 5-and 12-inches long is made between the ribs, separating them in order to view the lung. This procedure is often an option when the surgeon cannot clearly see the lung, making thoracoscopy difficult.
- Sternotomy: This technique involves dividing the breastbone in order to open the middle of the chest. This gives the surgeon access to both lung spaces and, thus, both lungs can be reduced through a single incision.
“Regardless of the technique used, it is the lung resection, not the operative approach, that is critical to the success of the operation,” Dr. Harris emphasizes.
Wow. So there you have it – sometimes you can make some sense out of these seemingly counterintuitive health concepts. Have you ever questioned how a certain health tip could possibly be beneficial … only to eventually find out that it actually worked? What was it?