Emphysema, also known as chronic obstructive pulmonary disease (COPD), is most commonly caused by smoking. The walls of the air sacs in the lung break down, so that they become abnormally enlarged, and the small airways to the sacs collapse. The result is increasing breathlessness.
Lung volume reduction surgery (LVRS), usually done using keyhole video surgery, is an effective treatment for some, but not all, emphysema patients. Removing the worst affected tissue, around 20–35 per cent of the lung volume, helps the remaining lung and surrounding muscles to work more efficiently, so that breathing is easier.
Patients are carefully assessed by Mr Scarci and his team to check whether LVRS is appropriate and likely to improve your quality of life without any unacceptable risk of complications. This assessment includes a thorough review of your medical history, lung function tests, and chest x-rays and CAT scans to check whether you have poorly functioning areas of your lung which could be surgically removed.
The best candidates for LVRS will have stopped smoking for at least six months. Before undergoing surgery all patients must take part in a six to ten week pulmonary rehabilitation programme. This is designed to optimise your ability to exercise and improve your recovery immediately after surgery.
Mr Scarci also offers a minimally invasive non-surgical method of lung volume reduction for carefully selected patients.
This ‘endoscopic lung volume reduction’ involves placing two to five small one-way valves into the worst affected areas of the lung. This is done through a bronchoscope (a flexible tube with a light and small camera) inserted through the nose or mouth, so there is no need for any surgical incisions.
The endobronchial valves allow air and secretions to escape the diseased areas of the lung, but stop air entering them when you breathe in. This reduction in lung volume gives more space for the healthier parts of the lung to expand, making breathing more comfortable and exercise easier.