Diseases of the lungs – surgical treatment
1. Big picture
Surgical treatment of lung diseases is mainly about deciding who benefits from resection or thoracoscopic intervention without causing unacceptable respiratory failure.
For the exam, think in three surgical questions:
1. Is the patient OPERABLE?
→ Can the patient physiologically tolerate surgery?
→ FEV1, diffusing capacity for carbon monoxide (DLCO/TLCO), exercise tolerance, cardiac status.
2. Is the disease RESECTABLE?
→ Can the lesion be completely removed anatomically?
→ CT, PET-CT, bronchoscopy, endobronchial ultrasound, mediastinal staging.
3. Is surgery CURATIVE or only palliative?
→ Early lung cancer, localized bronchiectasis, localized abscess, metastasectomy may be curative.
→ Advanced metastatic cancer, diffuse lung destruction, malignant pleural effusion usually are not curative.
The uploaded thoracic surgery material emphasizes the same logic: preoperative operability → intraoperative resectability → postoperative curability, and highlights the importance of CT/MRI/PET-CT, histological confirmation, mediastinal staging by PET/endobronchial ultrasound/endoscopic ultrasound/mediastinoscopy, lung function, DLCO, VO₂, coronary disease/ejection fraction, and one-lung selective intubation.
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