Interventional Pulmonary Procedures
Bronchoscopy is an endoscopic procedure which is critical in the initial diagnosis and staging of lung disease. Many patients with lung cancer, or other cancers metastatic to the lung, will have involvement of their airways (breathing tubes). This can lead to shortness of breath, cough, coughing up blood, as well as lung collapse and pneumonia. Bronchoscopy with newer specialized techniques for early diagnosis and staging, including EBUS and EUS, has revolutionized our approach to thoracic disease. In addition to diagnosis, we have multiple therapies available which can relieve or palliate these respiratory symptoms. These therapies include freezing of tumor (cryotherapy), burning of tumor (APC/Electrocautery), balloon dilatation, and placement of stents (rigid devices designed to open an airway). Your doctor will determine which therapy, or combination of therapies, is best for you after reviewing your labs, x-rays, as well as images from prior bronchoscopies. Sometimes, a bronchoscopy will need to be done in order to evaluate and help plan for your treatment.
These therapies can all be performed during flexible bronchoscopy (see flexible bronchoscopy above for details). You will be given medications to keep you moderately sedated, and most patients do not have any recall of the procedures. If a particular patient has a severe obstruction, this may require hospitalization for a few days in order to assure maximal safety.
If you are interested, please make an appointment. You will need to bring all x-rays and CT scans of your lungs, as well as any records from your referring doctor. You will see a doctor in clinic who will discuss the procedures with you.
Additional Pleural Procedures
Some patients who have a collection of fluid around the outside of the lung (a pleural effusion) will keep getting new effusions despite drainage from a thoracentesis. There are several conditions which can cause this. With the recurrence of the effusion, symptoms such as shortness of breath and cough may return. If this is the case, doctors here can perform procedures to help alleviate your symptoms.
A catheter can be placed into your pleural space. It will have a part outside of the skin on your chest. This outside part can be connected to a suction device, and the fluid around your lung will be drained. The catheter is placed under local anesthesia (no OR). You can then go home and drain your effusion daily from the comfort of your own home. Most patients tolerate this very well, with little or no discomfort. You should call if you have pain, redness, or swelling at the site of the catheter.
Our team can also perform a thoracoscopy. A small incision is made into your chest, and a tube with a camera is inserted into the space around your lung. The entire area can be viewed, and biopsies can be performed if necessary. Medications can be administered into this area which will help to stop the formation of the fluid. A small tube is left in place, and will remain until the fluid has stopped draining. This procedure is done under moderate sedation, with most patients not remembering the procedure. You will need to stay in the hospital while the tube remains in your chest, which can take from 24 hours to a few days. Most patients tolerate this well. Sometimes pain medications may be helpful in relieving discomfort.
If you are interested in these procedures, please call for an appointment. Your doctor will explain which procedure may be best for you, as well as the specific instructions about preparing for the procedure.