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Health & Wellness

Interventional Pulmonology role in diagnosis and treatment of lung disease

by Abhishek Tiwari May 29, 2019May 30, 2019
written by Abhishek Tiwari May 29, 2019May 30, 2019

Every cell in human body from tip of the hair to toe is important. Heart, brain, lungs are some of the vital organs of a human body.

Lungs act as a life support system in a human body and it’s complicated in its own different way.

Dr Sameer Arbat, MBBS, MD CHEST, Fellowship Interventional Pulmonology (Italy) Interventional Pulmonologist, KRIMS Hospitals has dealt with patients facing problems  on Interventional Pulmonology.

What is Interventional Pulmonology?

Interventional Pulmonology is a relatively new specialty in pulmonary medicine. Interventional Pulmonology uses minimally invasive endoscopic procedures for diagnosis and treatment of diseases of the airways, lungs, and pleura.

What are the various Interventional Pulmonology procedures?

Procedures for Interventional Pulmonology include flexible bronchoscopy, Bronchoscopic biopsies, Airway stent (bronchial stent), Rigid bronchoscopy, Thoracoscopy, Bronchial thermoplasty, Endobronchial ultrasound system (EBUS).

What are the advantages of Interventional Pulmonology ?

Interventional Pulmonology allows the pulmonologist to diagnose various lung diseases at an early stage and with higher accuracy. Early diagnosis helps in early and better treatment of the disease. The emergence of Intervention has been very important in diagnosis of lung cancer and its treatment. Interventional pulmonology procedures offer the potential advantage of avoiding more invasive surgery. For example, before Interventional Pulmonology, biopsy of lymph nodes in the chest required chest wall surgery which has many risks. Now biopsy of lymph nodes in the chest with an EBUS machine is an outpatient procedure, letting the patient go back home on the very same day.

What are the commonly encountered respiratory problems?

Common respiratory problems are asthma, COPD, pharyngitis, chronic bronchitis, tuberculosis, Interstitial Lung Diseases (ILDs), Pleural effusion, Sleep Apneas and lung cancer.

How are these respiratory problems diagnosed or treated with Interventional Pulmonology procedures?

Interventional Pulmonology has the advantage of early and accurate diagnosis and treatment of various respiratory problems. For example,

  • Bronchial Thermoplasty is a novel procedure used to treat asthma which is difficult to control with medicines.
  • Endobronchial Ultrasound or EBUS is essential for early diagnosis of lung cancer and Tuberculosis.
  • Patient with airway tumour and ILDs are diagnosed more accurately with Cryobiopsy.
  • Endobronchial stents are useful in improving the quality of life of patients of airway tumours.
  • Medical thoracoscopy is now emerging as a standard procedure for diagnosis and treatment of pleural effusion, which is basically fluid filling inside the chest wall.

What is EBUS?

EBUS or EndoBronchial UltraSound is a bronchoscope with an ultrasound probe attached to it. EBUS allows visualisation of lymph nodes around the heart for easy sampling. These lymph nodes get enlarged when a person is suffering from cancer or any infection. EBUS has a very high accuracy in diagnosing cancer, tuberculosis and sarcoidosis.

What is Cryobiopsy?

The Cryoprobe is an advanced instrument which can freeze the target tissue to a very low temperature. This frozen tissue can then be sampled or removed easily. Cryobiopsy is very useful for sampling of lung tissue or complete removal of tumour mass obstructing the airway. Cryobiopsy helps obtaining bigger samples thus giving higher accuracy and avoiding repeat procedures.

What is Rigid Bronchoscopy?

The rigid bronchoscope has a larger diameter which allows the doctor to use more sophisticated surgical tools and techniques to take biopsies, put airway stents or remove inhaled foreign objects. This is always performed under general anaesthesia inside an Operation Theatre.

What are Airway Stents?

Airway stent or bronchial stents are made of metal or silicon. Using a bronchoscope, a stent is put in a narrowed airway which is often caused due to cancer or tuberculosis. These stents are often life saving in such cases.

Are there any risks involved in all these interventional procedures?

Most of these procedures are associated with minimal risks, most common being bleeding or cough, both of which can be easily controlled with medicine. Many of these procedures are performed on a day-care basis and the patient can go home on the very same day. Also, it is imperative that only experts skilled in the use of this equipment’s should perform Interventional procedures.

Are these procedures routinely performed in Nagpur city?

Yes. The department of Pulmonology at KRIMS Hospitals, Nagpur has been a pioneer department in the country and has been offering advanced Interventional care since past 30 years. We are the first and only department in Central India to have both the Cryotherapy and EBUS Unit. We have performed more than 800 procedures in the past 3 years including thoracoscopies, cryobiopsy and EBUS. Our team comprises of 6 dedicated pulmonologists with a fully equipped ICU and critical care team.

Do you advise any steps to avoid lung diseases?

Yes, it is very essential for everyone to adapt a healthy lifestyle which includes healthy diet and regular exercise. Smokers should quit smoking, which includes cigarettes, E- cigarettes and hukka or sheesha. Regular health check up can also help in preventing complications. Patients suffering from respiratory problems should take their medicines regularly and have a regular follow up with the doctor.

As the world will celebrate No tobacco day on May 31, one should avoid consuming products like cigarettes, sheesha, tobacco for a healthy and better life. Say No to Tobacco.

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Abhishek Tiwari

Lead Content Curator at TheLiveNagpur

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