Breathing deeply

Belarusian surgeons second in the world to perform complex lung transplant
By Yevgeny Mikhnichenko

We take our lung function for granted but, of course, viruses, infections, pollution and stress can affect our ability to breathe freely. Belarusian surgeons have been successfully operating on patients with severe lung problems for several years now but the latest surgery, performed on Vadim Nikolaevich, 58, is a landmark event.

Just three weeks ago, he had no idea of even needing surgery. However, the discovery of a tumour in his left lung requiring immediate surgery, and another lump in the right lung, left no time to waste. The Department of Thoracic Surgery and Lung Transplantation at the Republican Scientific and Practical Centre of Organ and Tissue Transplants decided to attempt one of the world’s most complex operations: autologous transplantation of basal segments of the lower lobe of the lung. It was the first such operation in Belarus.

“Usually, in such cases, the entire affected organ is removed by pneumonectomy,” explains Sergey Yeskov, who heads the department. “In this situation, we could not do so, since both lungs were affected. We had to save at least part of the left lung at all costs…. so we did.”

The affected organ was removed from the chest cavity, allowing the upper lobe and the sixth segment of the lower lobe to be cut away. The remaining, smaller lung would be able to operate, and was replaced into the pleural cavity. Nine surgeons took part over the six-hour operation while a similar number are being involved in Vadim’s rehabilitation.

“The operation was technically difficult since the lung was almost halved in size, making it tricky to return it to its original location in the chest,” Ms. Yeskov tells us. “We had to match up bronchi with different diameters and connect the pulmonary artery to the central part of the vessel, using scraps of segmental arteries. We sewed a lower pulmonary vein directly into the left atrium.”

The only other nation to attempt such an operation is Japan, which was the first to risk the surgery, working on part of the lung.

“The department has existed for only three months, but has already conducted rare, high-tech operations,” Mr. Yeskov asserts proudly. “We’re ready to help not only fellow citizens, but foreigners.”
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