Nine complex surgeries performed in just 20 days, including lobectomy on 15-year-old patient with aspergilloma

Raipur/ The Department of Cardiothoracic and Vascular Surgery at Dr. Bhimrao Ambedkar Memorial Hospital, affiliated to Pt. Jawaharlal Nehru Memorial Medical College, Raipur, has achieved a significant milestone by successfully performing nine lung lobectomies in 20 days, taking the total to 13 such surgeries in the past two months. The patients, aged 15 to 70 years, included a 15-year-old who underwent lobectomy for aspergilloma, a fungal infection caused by Aspergillus niger, in the upper lobe of the left lung. The patient is the youngest to undergo lung lobectomy at the institution so far.

Two of the recent procedures were emergency surgeries performed on patients suffering from severe bleeding while coughing, a condition known as haemoptysis. The complex procedures were performed using advanced technology and an advanced lung stapler, which substantially reduces the risk of post-operative complications such as bronchopleural fistula.

Department Head Shri Dr. Krishnakant Sahu said lobectomy involves surgically removing a diseased portion or lobe of the lung and is a highly complex procedure. The hospital uses advanced techniques and lung staplers, which help minimise the possibility of bronchopleural fistula and other complications. Performing 13 lobectomies in two months, including nine in just 20 days, is a record for the institution and a matter of pride for Chhattisgarh, he said.

In Chhattisgarh, the major indications for lung lobectomy are aspergilloma and bronchiectasis. Aspergilloma is caused by Aspergillus niger and commonly affects patients with a history of pulmonary tuberculosis or those with severely reduced immunity. It is generally found most frequently in the upper lobe of the right lung, where conditions can favour the growth of tuberculosis bacteria and the Aspergillus fungus.

Bronchiectasis is also a common condition following pulmonary tuberculosis. It causes small cavities in the lungs, which can become infected and lead to bleeding while coughing. Vascular malformations and lung abscesses, which can produce large cavities in the lung, are also major causes of haemoptysis. Vascular malformations and lung cancer are further important causes of blood in sputum. When lung cancer is detected at an early stage, lobectomy can provide complete treatment in appropriate cases.

The Cardiothoracic and Vascular Surgery Department performs the highest number of lung surgeries in Chhattisgarh, including decortication, lobectomy, segmentectomy and pneumonectomy. In a pneumonectomy, the entire right or left lung is surgically removed.

The hospital normally performs around 15 to 20 lung lobectomies a year. Patients seeking lung surgery come not only from Chhattisgarh but also from neighbouring states, including Bihar, Jharkhand, Odisha, Madhya Pradesh and Uttar Pradesh, which is a matter of pride for the institution.

All these surgeries are performed free of cost under the Ayushman scheme. Some patients are currently awaiting lobectomy at the department.

What is a lung lobectomy?

The human lungs consist of two sides, the right and left lungs. The left lung has two lobes: upper and lower, while the right lung has three lobes: upper, middle and lower.

When a disease such as aspergilloma, bronchiectasis or a lung tumour is confined to a particular lobe, that diseased portion can be surgically removed. This procedure is known as a lobectomy. The surgeon makes an incision on the right or left side of the chest, separates the diseased portion from the remaining lung and removes the affected lobe using specialised techniques and a lung stapler.

The use of modern stapling technology significantly reduces post-operative complications such as bronchopleural fistula. Patients are generally discharged six to eight days after surgery.