In the UK, around 1.2 million people are affected by COPD.
Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that accounts for both emphysema and chronic bronchitis, and is defined by an obstruction to the outflow of air.
Smoking is the main risk factor which is responsible for gradual lung tissue changes and worsening over time. COPD usually becomes symptomatic normally at middle-age with progressive limitations on daily activities (i.e. walking up and downstairs). With emphysema, the air spaces within the lung are damaged and overinflated, and due to chronic exposure to irritants (such as smoke), disruption of lung tissue ultimately causes the formation of bullae. The presence of bullae, especially when great, may cause worsening of the breathing dynamics, which leads to progressive overinflation and this compresses a healthy lung and ruptures with air leaking outside the lung within the chest (pleural space).
Treatment
COPD is managed by substantial lifestyle changes including stopping smoking, medication (i.e. inhalers), respiratory physiotherapy and, in severe cases, home oxygen therapy. The main role of surgery in COPD is most commonly that one related to the cure of secondary pneumothorax (rupture of a bulla and presence of air in the pleural space). Depending on a patient’s fitness for surgery, options vary between bullae resection and chemical pleurodesis (stimulating adherences formation between the lung and the chest wall by using talc), under general anesthesia, and talc instillation through a chest tube under local anesthesia.
In selected patients, mostly those having a non-uniform pattern of emphysema changes at CT scan, surgery with excision of selected damaged areas of the lung might be considered with the aim of leaving the space for the ‘healthier’ parenchyma to work better, thus recovering some degree of lost pulmonary function.
Surgery on a severe COPD lung carries significant added risks over the normal population of post-operative low tract respiratory infections, prolonged air leak and postoperative respiratory insufficiency.
To book a consultation with Mr Granato, please call 0161 393 3993 or email felice.granato@consultantcare.com.