Introduction
If classic symptoms of a lung disease such as acute chest pain, shortness of breath (dyspnoea), reduced performance or even an effusion in the lungs already occur – but also in the case of accidental findings through preventive medical checkups or similar – it is always advisable to clarify where exactly the cause of these signs lies and whether treatment is appropriate under certain circumstances. In the case of the lung, there are many different diseases that can be the cause of a functional disorder or reduction. Of these, some are easily treatable or even do not require treatment at all, while others belong to the group of lung diseases that require surgical treatment and special procedures.
In this group, once again, diseases that should always be treated surgically can be distinguished from those for which surgery is appropriate in certain situations or as a last resort. Common to all diseases of the lung that require surgical treatment is that the ventilation of the lungs is generally disturbed or the oxygen exchange within the organ shows a problem. In most cases, this manifests itself as shortness of breath and significantly reduced performance.
The other signs are usually rather unspecific and therefore not clearly assignable. If it is a lung disease that requires surgical treatment, a narrowly defined, clearly definable cause can be found as the reason for the symptoms with the help of imaging techniques (X-ray examination, CT). If the cause cannot be found, or if it cannot be clearly visualized and defined, it may be assumed that the situation is inoperable, making an alternative treatment necessary.
Common surgical indications
Lung diseases requiring surgical treatment include diseases from the large group of neoplasias, i.e. new tissue formation, as well as acute injuries with a risk of bleeding, such as those occurring after accidents. New tissue formations include lung carcinoma, in which a small cell carcinoma can be distinguished from non-small cell carcinomas and neuroendocrine carcinomas, but also other masses of space within the lung (in general: tumor), metastases of a tumor disease localized elsewhere that have only settled in the lung during the course of the disease, and the so-called pleural mesothelioma (malignant tumor of the cells surrounding the lung, which surrounds the lung in a mantle and is often associated with asbestos exposure). The second category – surgery after injury – includes all accidents and traumatic events that are associated with heavy and prolonged bleeding (> 200ml blood loss every hour) and/or cannot be controlled conventionally (= without surgical intervention). For example, large bruises of the lung tissue (lung contusion), tears within the lung (rupture) and naturally penetrating lung injuries (stab, spit, bullet wounds) are in most cases diseases of the lung that require surgical treatment.
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