Correspondent Jiang Yuhui Zhang Quanlu
Mother Wang, from Wuhan, 67 years old, has suffered from bronchiectasis for six or seven years and has not received standard treatment. Last week, I had an unbearable cough. When I came to the city’s lung hospital for medical treatment, I knew that surgery was necessary. It was confirmed during the operation that the part removed under the knife not only breeds various pathogenic bacteria, but also has cancerous tissue. Coincidentally, there was a lady Yu in the same ward who shared the same illness with her, and she has also been dragged into cancer. Experts suggest that bronchiectasis cannot be allowed to develop.
Jiang Yuhui (right) is performing single-port thoracoscopic surgery with colleague Liu Xiaoyu
Wang After my mother-in-law was over 60 years old, she began to notice chest discomfort. When she coughed heavily, she would cough up blood. Doctors in many hospitals suggested that she had bronchiectasis and needed to be treated according to the doctor’s order. The mother-in-law felt that it was okay, so she went to take anti-inflammatory injections when she coughed. However, the symptoms were not cured, and not long after, she still coughed and coughed up blood. Repeatedly, six or seven years have passed without realizing it.
Last week, Granny Wang had an unbearable cough and felt that her condition was getting worse, so she came to Wuhan Pulmonary Hospital for treatment. The deputy chief physician of the No. 2 Respiratory Ward, Yang Chengming, inferred from the symptoms that the mother-in-law’s dilated bronchi was likely to have been inhabited by bacteria, and the hemoptysis was related to this.
Yang Chengcheng manipulated the bronchoscope into her mother-in-law’s bronchus for examination. It was found that her right middle lobe bronchiectasis had been very serious, some of which had been damaged, and Aspergillus was cultured in the bronchial lavage fluid.
Because bronchiectasis is an irreparable change in the anatomical structure of the lung, after joint research and judgment by the respiratory department and surgical experts, it was decided to perform surgical treatment on Granny Wang.
Intraoperative examinations revealed that in addition to the stubborn Aspergillus, there was also a rare pathogen, Mycobacterium intracellulare, on the lesions. What surprised doctors and patients even more was that the pathologist also found some cells with special shapes in the lungs, which turned out to be cancerous lung tissue. Fortunately, these cancerous tissues were discovered in time and removed with minimally invasive surgery.
Coincidentally, there was a 57-year-old Ms. Yu who was admitted to the hospital with her mother-in-law Wang. She coughed and sputum repeatedly for more than ten years. Many hospitals diagnosed bronchiectasis and infection, resulting in cavities in the lungs. Ms. Yu underwent surgery at the Municipal Pulmonary Hospital. Intraoperative pathological examination also found cancerous tissue. Thanks to early detection, the lesions were removed by minimally invasive surgery.
At present, Wang and Yu have been cured and discharged from the hospital yesterday.
Dr. Jiang Yuhui introduced that bronchiectasis and pulmonary cavities are common structural lung diseases. Due to the destruction of the normal structure of the lungs, the ability to expel sputum decreases, and the dilated bronchi and sputum accumulate in the cavities, which are easy to cause. Bacteria such as Aspergillus breed, erode lung tissue, and cause hemoptysis. At the same time, the blood flow and ventilation function of these abnormal parts are often abnormal, and it is difficult for drugs to penetrate into and effectively sterilize. What’s more, long-term and repeated inflammatory stimulation causes cells to undergo genetic mutations and eventually turn into malignant tumors.
For these patients with irreversible pulmonary structure damage, clinical treatment is more difficult. Drug therapy alone can only temporarily control the disease, but it is difficult to cure. However, for some patients with relatively limited lesions, surgery can completely remove the abnormal lung to achieve the purpose of removing the root of the disease, and the treatment effect is relatively good.