They removed the lung and what breathing exercises to do. Complex of therapeutic exercises after surgery

24.04.2021 Hobbies and entertainment

Unfortunately, in case of lung injuries, diseases or complications, surgery is sometimes needed. After surgical treatment, a long recovery period is needed, in which breathing exercises, exercise therapy exercises, and special gymnastic exercises help. After dangerous injuries that occur due to damage to the bone corset of the chest, it is possible to injure the lung with a rib, as well as damage to the circulatory system, air entering the cavity behind the pleura. Also, operations are needed for suppuration of the lungs, tumors, while it is possible to remove part or all of the lung. At the same time, the operations themselves are very traumatic - to get to the respiratory organ, you need to go through the muscles, cartilage and the ribs themselves. Surgeons restore tightness and respiratory function, but you need to restore the functionality and fullness of breathing yourself.

Before surgery

People usually endure lung surgery very hard, so it is advisable to prepare them for this traumatic intervention with the help of gymnastic and physical exercises. Special exercises help with suppuration in the lungs, which cause intoxication. Due to the accumulation of pus in the lungs, which is accompanied by hemoptysis, it becomes harder to breathe, the human heart and brain work worse. Special physical activity helps to improve respiratory functions. Exercises to be done after surgery are also studied.

Of course, if there is bleeding in the lungs, the body temperature rises above 38 degrees, but without sputum accumulation, or third-degree cardiovascular insufficiency is diagnosed, there can be no talk of any therapeutic exercises, since it can be harmful and, possibly The patient needs to be operated on urgently.

After surgery

During surgery internal organs receive serious injuries. Not only muscles and ribs are damaged, but also nerve endings, which leads to pain after surgery, which, together with depression of the respiratory center, leads to superficial gas exchange, impaired lung drainage. After the operation, other complications also arise - contracture of the shoulder joint. pain, embolism, thrombosis, pneumonia, intestinal atony, problems with the intestines and others.

In the postoperative period, it is necessary to improve the performance of one part of the lung that has been preserved, to avoid complications, adhesions between the pleurae, and to develop the shoulder joint. Therapeutic exercises are prescribed for several hours after the operation, including breathing, since the patient must clear his throat.

Exercise in bed

Recovery exercises

After the operation, you need to examine the lung, whether it has expanded enough, if not, inflammation of individual areas is possible, which is preceded by shortness of breath. So check with your doctor regularly. Up to three months you need to do exercises that ventilate the lungs. You can do your homework, you need to eat in moderation without overeating. And, since this is a recovery process, nutrition should be healthy. You need to quit smoking and drinking, of course.

Surgery on the lungs requires preparation from the patient and compliance with restorative measures after its completion. They resort to removing the lung in severe cases of cancer. Oncology develops imperceptibly and can manifest itself already in a malignant state. Often people do not go to the doctor with minor ailments, indicating the progression of the disease.

Types of surgery

Lung surgery is performed only after a complete diagnosis of the patient's body. Doctors are required to make sure that the procedure is safe for a person who has a tumor. Surgical treatment should take place immediately, until the oncology has spread further through the body.

Lung surgery is of the following types:

Lobectomy - removal of the tumor part of the organ. Pulmonectomy involves the complete excision of one of the lungs. Wedge resection - point surgery of the chest tissue.

For patients, lung surgery seems like a death sentence. After all, a person cannot imagine that his chest will be empty. However, surgeons are trying to reassure patients, there is nothing terrible in this. Concerns about difficulty breathing are unfounded.

Preliminary preparation for the procedure

An operation to remove a lung requires preparation, the essence of which is to diagnose the state of the remaining healthy part of the organ. After all, you need to be sure that after the procedure a person will be able to breathe, as before. Wrong decision can lead to disability or death. They also evaluate general well-being, not every patient can withstand anesthesia.

The doctor will need to collect tests:

urine; the results of the study of blood parameters; chest X-ray; ultrasound examination of the respiratory organ.

An additional study may be required if the patient has diseases of the heart, digestive or endocrine system. Under the ban fall drugs that help thin the blood. At least 7 days must elapse before the operation. The patient sits on a therapeutic diet, bad habits will need to be excluded before visiting the clinic and after a long period of recovery of the body.

Essentials of chest surgery

Surgical removal takes a long time under anesthesia for at least 5 hours. Based on the pictures, the surgeon finds a place for an incision with a scalpel. The tissue of the chest and pleura of the lung is dissected. Adhesions are cut off, the organ is released for extraction.

The surgeon uses clamps to stop bleeding. The drugs used in anesthesia are checked in advance so as not to cause anaphylactic shock. Patients may have an acute allergic reaction to the active substance.

After removal of the whole lung, the artery is fixed with a clamp, then the nodes are superimposed. Sutures are made with absorbable threads that do not require removal. Inflammation is prevented by a saline solution pumped into the chest: into the cavity, which is located in the gap between the pleura and the lung. The procedure ends with a forced increase in pressure in the ways of the respiratory system.

Recovery period

After surgery on the lung, precautions must be taken. The entire period is under the supervision of the surgeon who performed the procedure. After a few days, begin to carry out restoring mobility exercises.

Respiratory movements are carried out lying down, sitting and during a walk. The task is simple - to reduce the period of treatment through the restoration of pectoral muscles weakened by anesthesia. Home therapy is not painless, tight tissues are gradually released.

With severe pain, it is allowed to use painkillers. Appeared edema, purulent complications or lack of inhaled air should be eliminated together with the attending physician. Discomfort when moving the chest persists for up to two months, which is the normal course of the recovery period.

Additional help with rehabilitation

The patient spends several days in bed after the operation. Removing the lung has unpleasant consequences, but simple remedies help to avoid the development of inflammation:

The dropper supplies the body with anti-inflammatory substances, vitamins, the required amount of fluid for the normal functioning of internal organs and maintaining metabolic processes at the proper level. You will need to install tubes in the incision area, fixed with a bandage between the ribs. The surgeon may leave them on for the entire first week. You have to put up with the inconvenience for the sake of future health.

If the lung cancer has already been removed, after the operation, about a week of treatment in the hospital takes place. After being discharged, they continue to do physical exercises, take anti-inflammatory drugs until the seam disappears completely.

Prerequisites for treatment by a surgeon

Tumors in the lungs appear due to the following factors:

Tuberculosis.Cyst.Echinococcosis.Fungi.Injuries.

Infections are on a par with other provocateurs: bad habits (smoking, alcoholism), chronic diseases (thrombosis, diabetes), obesity, long-term drug therapy, severe allergic reaction. The lungs are checked periodically for the timely determination of pathological conditions.

So, it is recommended to have an examination of the lungs once a year. Particular attention is paid to patients suffering from vascular diseases. If the disease is started, the dying tissue of the tumor will provoke further growth of pathological cells. Inflammation will spread to neighboring organs or go deep into the body through the bloodstream.

The cyst in the lungs does not remain in its original form. It gradually grows, squeezing the sternum. There is discomfort and pain. Compressed tissues begin to die, causing the appearance of purulent foci. Similar consequences are observed after injury, rib fracture.

Can the diagnosis be wrong?

In very rare cases, a diagnostic error occurs with the conclusion “lung tumor”. Surgery in such situations may not be the only way out. However, doctors still resort to removing the lung for reasons of preserving human health.

In severe complications, the affected tissue is recommended to be removed. The decision to operate is based on clinical symptoms and imaging. The pathological part is removed to stop the growth of tumor cells. There are cases miraculous healing, but it is unreasonable to hope for such an outcome. Surgeons are used to being realistic, because we are talking about saving the patient's life.

The need for lung surgery always causes a reasonable fear both in the patient and his relatives. On the one hand, the intervention itself is quite traumatic and risky, on the other hand, operations on the respiratory organs are indicated for persons with a serious pathology, which, without treatment, can lead to the death of the patient.

Surgical treatment of lung diseases places high demands on the general condition of the patient, as it is often accompanied by a large surgical injury and a long period of rehabilitation. Interventions of this kind should be taken seriously, with due attention to both preoperative preparation and subsequent recovery.

The lungs are a paired organ located in the chest (pleural) cavities. Life without them is impossible, because the main function of the respiratory system is to deliver oxygen to all tissues of the human body and remove carbon dioxide. At the same time, having lost a part or even a whole lung, the body can successfully adapt to new conditions, and the remaining part of the lung parenchyma is able to take on the function of the lost tissue.

The type of lung surgery depends on the nature of the disease and its prevalence. Whenever possible, surgeons preserve the maximum volume of the respiratory parenchyma, if this does not contradict the principles of radical treatment. IN last years modern minimally invasive techniques are successfully used to remove lung fragments through small incisions, which contributes to the fastest recovery and a shorter recovery period.

When is lung surgery needed?

Operations on the lungs are carried out if there is a serious reason for this. Indications include:

Tumors and some forms of tuberculosis are considered the most common cause of lung surgery. In case of lung cancer, the operation includes not only the removal of a part or the whole organ, but also the excision of the lymphatic drainage pathways - the intrathoracic lymph nodes. With extensive tumors, resection of the ribs and pericardial sections may be required.

types of operations in the surgical treatment of lung cancer

Types of interventions on the lungs depend on the amount of tissue removed. So, pulmonectomy is possible - removal of the whole organ, or resection - excision of a fragment of the lung (lobe, segment). With the widespread nature of the lesion, massive cancer, disseminated forms of tuberculosis, it is impossible to rid the patient of the pathology by removing only a fragment of the organ, therefore, radical treatment is indicated - pulmonectomy. If the disease is limited to a lobe or segment of the lung, then it is enough to excise only them.

Traditional open surgeries are performed in cases where the surgeon is forced to remove a large volume of the organ. Recently, they have given way to minimally invasive interventions that allow excising the affected tissue through small incisions - thoracoscopy. Among modern minimally invasive methods of surgical treatment, the use of a laser, an electric knife, and freezing are gaining popularity.

Features of operations

During interventions on the lung, accesses are used that provide the shortest path to the pathological focus:

Anterior-lateral; Side; Posterior-lateral.

Anterior-lateral approach means an arcuate incision between the 3rd and fourth ribs, starting slightly laterally from the parasternal line, extending to the posterior axillary. The posterior-lateral lead from the middle of the third or fourth thoracic vertebrae, along the paravertebral line to the angle of the scapula, then along the sixth rib to the anterior axillary line. The lateral incision is made with the patient lying on the healthy side, from the midclavicular line to the paravertebral line, at the level of the fifth to sixth rib.

Sometimes, in order to reach the pathological focus, it is necessary to remove sections of the ribs. Today, it has become possible to excise not only a segment, but also an entire lobe by thoracoscopic when the surgeon makes three small incisions about 2 cm and one up to 10 cm, through which instruments are inserted into the pleural cavity.

Pulmonectomy

Pulmonectomy is an operation to remove the lung, which is used in cases of damage to all its lobes in common forms of tuberculosis, cancer, and purulent processes. This is the most significant operation in terms of volume, because the patient immediately loses a whole organ.

The right lung is removed from the anterolateral or posterior approach. Once in the chest cavity, the surgeon first of all bandages the elements of the lung root separately: first the artery, then the vein, the bronchus is tied up last. It is important that the bronchus stump is not too long, because this creates a risk of stagnation of the contents in it, infection and suppuration, which can cause suture failure and inflammation in the pleural cavity. The bronchus is sutured with silk or sutures are applied using a special device - a bronchus stapler. After ligation of the elements of the lung root, the affected organ is removed from the chest cavity.

When the bronchus stump is sutured, it is necessary to check the tightness of the sutures, which is achieved by forcing air into the lungs. If everything is in order, then the area of the vascular bundle is covered with a pleura, and the pleural cavity is sutured leaving drains in it.

The left lung is usually removed from the anterolateral approach. The left main bronchus is longer than the right, so the doctor must be careful not to make his stump long. Vessels and bronchus are treated in the same way as on the right side.

Pulmonectomy (pneumonectomy) is performed not only for adults, but also for children, but age does not play a decisive role in choosing a surgical technique, and the type of operation is determined by the disease (bronchiectasis, polycystic lung, atelectasis). In severe pathology of the respiratory system requiring surgical correction, expectant management is not always justified, since many processes can disrupt the growth and development of a child with untimely treatment.

Removal of the lung is performed under general anesthesia, the introduction of muscle relaxants and tracheal intubation for ventilation of the organ parenchyma are mandatory. In the absence of an obvious inflammatory process, drains may not be left, and the need for them arises when pleurisy or other effusion appears in the chest cavity.

Lobectomy

A lobectomy is the removal of one lobe of the lung, and if two are removed at once, the operation is called a bilobectomy. This is the most common type of lung surgery. Indications for lobectomy are tumors limited to the lobe, cysts, some forms of tuberculosis, single bronchiectasis. Lobectomy is also performed in oncopathology, when the tumor is local and does not spread to surrounding tissues.

lobectomy

The right lung has three lobes, the left has two. The upper and middle lobes of the right and the upper lobe of the left are removed from the anterior-lateral access, the lower lobe of the lung is removed from the postero-lateral.

After opening the chest cavity, the surgeon finds the vessels and bronchus, bandaging them individually in the most minimally traumatic way. First, the vessels are processed, then the bronchus, which is stitched with a thread or a bronchus stitcher. After these manipulations, the bronchus is covered with a pleura, and the surgeon removes the lobe of the lung.

After a lobectomy, it is important to straighten the remaining lobes during the operation. To do this, oxygen is pumped into the lungs under high pressure. After the operation, the patient will have to independently straighten the lung parenchyma by performing special exercises.

After a lobectomy, drains are left in the pleural cavity. With an upper lobectomy, they are installed through the third and eighth intercostal space, and when removing the lower lobes, one drainage inserted into the eighth intercostal space is sufficient.

segmentectomy

A segmentectomy is an operation to remove a part of the lung called a segment. Each of the lobes of the organ consists of several segments that have their own artery, vein and segmental bronchus. It is a self-contained lung unit that can be excised safely to the rest of the organ. To remove such a fragment, use any of the accesses that provide the shortest path to the affected area of the lung tissue.

Indications for segmentectomy are small lung tumors that do not extend beyond the segment, a lung cyst, small segmental abscesses and tuberculous cavities.

After dissection of the chest wall, the surgeon isolates and bandages the segmental artery, vein, and lastly, the segmental bronchus. The selection of a segment from the surrounding tissue should be made from the center to the periphery. At the end of the operation, drains are installed in the pleural cavity, respectively, of the affected area, and the lung is inflated with air. If a large number of gas bubbles are released, then the lung tissue is sutured. X-ray control is required before the closure of the surgical wound.

Pneumolysis and pneumotomy

Some operations on the lungs are aimed at eliminating pathological changes, but are not accompanied by the removal of its parts. These are considered pneumolysis and pneumotomy.

Pneumolysis is an operation to cut adhesions that prevent the lung from expanding, filling with air. A strong adhesive process accompanies tumors, tuberculosis, suppurative processes in the pleural cavities, fibrinous pleurisy in kidney pathology, extrapulmonary neoplasms. Most often, this type of operation is performed for tuberculosis, when abundant dense adhesions are formed, but the size of the cavity should not exceed 3 cm, that is, the disease should be limited. Otherwise, more radical intervention may be required - lobectomy, segmentectomy.

Dissection of adhesions is carried out extrapleurally, intrapleurally or extraperiosteally. In extrapleural pneumolysis, the surgeon peels off the parietal pleural sheet (external) and introduces air or liquid paraffin into the chest cavity to prevent the lung from swelling and the formation of new adhesions. Intrapleural dissection of adhesions is performed by penetrating under the parietal pleura. The extraperiosteal method is traumatic and has not found wide application. It consists in peeling off the muscle flap from the ribs and introducing polymer balls into the resulting space.

Adhesions are dissected using a hot loop. Instruments are inserted into that part of the chest cavity where there are no adhesions (under X-ray control). To access the serous membrane, the surgeon resects sections of the ribs (the fourth in case of an upper lobe lesion, the eighth in case of a lower lobe lesion), exfoliates the pleura and sutures the soft tissues. The entire treatment process takes up to one and a half to two months.

lung abscess

Pneumotomy is another type of palliative surgery, which is indicated for patients with focal purulent processes - abscesses. An abscess is a cavity filled with pus that can be evacuated to the outside through an opening in the chest wall.

Pneumotomy is also indicated for patients with tuberculosis, tumors and other processes that require radical treatment, but which is impossible due to a serious condition. Pneumotomy in this case is designed to alleviate the patient's well-being, but will not help to completely get rid of the pathology.

Before performing a pneumotomy, the surgeon necessarily performs a thoracoscopy in order to find the shortest path to the pathological focus. Then fragments of the ribs are resected. When access to the pleural cavity is obtained and provided that there are no dense adhesions in it, the latter is plugged (the first stage of the operation). After about a week, the lung is dissected, and the edges of the abscess are fixed to the parietal pleura, which ensures the best outflow of pathological contents. The abscess is treated with antiseptics, leaving tampons moistened with a disinfectant in it. If there are dense adhesions in the pleural cavity, then pneumotomy is performed in one stage.

Before and after surgery

Operations on the lungs are traumatic, and the condition of patients with pulmonary pathology is often severe, therefore it is very important proper preparation for upcoming treatment. In addition to standard procedures, including a general blood and urine test, a biochemical blood test, a coagulogram, a chest x-ray, CT, MRI, fluoroscopy, ultrasound chest organs.

With purulent processes, tuberculosis or tumors, by the time of the operation, the patient is already taking antibiotics, anti-tuberculosis drugs, cytostatics, etc. An important point in preparing for lung surgery is breathing exercises. In no case should it be neglected, since it not only contributes to the evacuation of contents from the lungs even before the intervention, but is also aimed at straightening the lungs and restoring respiratory function after treatment.

In the preoperative period, the exercise therapy methodologist helps to perform the exercises. A patient with abscesses, caverns, bronchiectasis should make turns and tilts of the body while raising the arm. When the sputum reaches the bronchus and causes a cough reflex, the patient leans forward and down, making it easier to cough out. Weakened and bedridden patients can perform exercises while lying in bed, while the head end of the bed drops slightly.

Postoperative rehabilitation takes an average of about two weeks, but can stretch for a longer period of time, depending on the pathology. It includes the treatment of a postoperative wound, the change of dressings, tampons during pneumotomy, etc., compliance with the regimen and exercise therapy.

The consequences of the transferred treatment may be respiratory failure, secondary purulent processes, bleeding, suture failure and pleural empyema. For their prevention, antibiotics, painkillers are prescribed, and discharge from the wound is monitored. Respiratory gymnastics is obligatory, which the patient will continue to perform at home. Exercises are performed with the help of an instructor, and they should be started within a couple of hours from the moment you wake up from anesthesia.

life expectancy after surgical treatment lung diseases depends on the type of intervention and the nature of the pathology. So, when removing single cysts, small tuberculous foci, benign tumors, patients live as long as other people. In the case of cancer, severe purulent process, gangrene of the lung, death can occur from septic complications, bleeding, respiratory and heart failure at any time after the intervention, if it did not contribute to the achievement of a stable state.

With a successful operation, the absence of complications and progression of the disease, the prognosis is generally good. Of course, the patient will need to monitor his respiratory system, there can be no talk of smoking, breathing exercises will be needed, but with the right approach, healthy lobes of the lungs will provide the body with the necessary oxygen.

Disability after operations on the lungs reaches 50% or more and is indicated for patients after pneumonectomy, in some cases after lobectomy, when the ability to work is impaired. The group is assigned in accordance with the patient's condition and is periodically reviewed. After a long period of rehabilitation, most of those operated on restore both their health and ability to work. If the patient has recovered and is ready to return to work, then the disability can be removed.

Operations on the lungs are usually performed free of charge, because this is required by the severity of the pathology, and not by the patient's desire. Treatment is available in the departments of thoracic surgery, and many operations are performed under the CHI system. However, the patient can also undergo paid treatment in both public and private clinics, paying for both the operation itself and comfortable conditions in the hospital. The cost varies, but it cannot be low, because lung surgery is complex and requires the participation of highly qualified specialists. Pneumonectomy on average costs about 45-50 thousand, with excision of mediastinal lymph nodes - up to 200-300 thousand rubles. Removing a share or segment will cost from 20 thousand rubles in a state hospital and up to 100 thousand in a private clinic.

Pulmonary diseases are very diverse, and doctors use different methods to treat them. In some cases, therapeutic measures are ineffective, and in order to overcome a dangerous disease, one has to use surgery.

Lung surgery is a forced measure that is used in difficult situations when there is no other way to cope with the pathology. But many patients experience anxiety when they find out that they need such an operation. Therefore, it is important to know what such an intervention is, whether it is dangerous, and how it will affect a person’s future life.

It should be said that chest surgeries using the latest technologies do not pose any threat to health. But this is true only if the doctor who is involved in the implementation has a sufficient level of qualification, and also if all precautions are observed. In this case, even after a serious surgical intervention, the patient will be able to recover and live a full life.

Indications and types of operations

Operations on the lung are not performed without special need. The doctor first attempts to cope with the problem without using drastic measures. However, there are situations when surgery is necessary. This:

congenital abnormalities; lung injury; the presence of neoplasms (malignant and non-malignant); pulmonary tuberculosis in severe form; cysts; pulmonary infarction; abscess; atelectasis; pleurisy, etc.

In any of these cases, it is difficult to cope with the disease using only medications and therapeutic procedures. However, at the initial stage of the disease, these methods can be effective, which is why it is so important to seek help from a specialist in a timely manner. This will avoid the use of radical treatment measures. So even in the presence of these difficulties, the operation may not be prescribed. The doctor should be guided by the characteristics of the patient, the severity of the disease and many other factors before making such a decision.

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Operations that are performed for lung diseases are divided into 2 groups. This:

Pneumoectomy. Otherwise, such an operation is called a pulmonectomy. It involves the complete removal of the lung. It is prescribed in the presence of a malignant tumor in one lung or with a wide distribution of pathological foci in the lung tissues. In this case, it is easier to remove the whole lung than to separate the damaged areas. Removal of the lung is the most significant operation, since half of the organ is eliminated.

This type of intervention is practiced not only in relation to adults, but also for children. In some cases, when the patient is a child, the decision to perform such an operation is made even faster, since pathological processes in the damaged organ interfere with the normal development of the body. An operation is performed to remove the lung under general anesthesia.

Lung resection. This type of intervention involves the removal of a part of the lung, the one in which the focus of the pathology is located. Lung resection is of several types. This:

atypical lung resection. Another name for this operation is marginal lung resection. During it, one section of the organ located on the edge is removed; segmentectomy. Such resection of the lungs is practiced when a separate segment is damaged along with the bronchus. Intervention involves the removal of this area. Most often, when it is carried out, there is no need to cut the chest, and the necessary actions are performed using an endoscope; lobectomy. This type of operation is practiced when the lung lobe is affected, which has to be removed surgically; bilobectomy. During this operation, two lobes of the lung are removed; removal of a lung lobe (or two) is the most common type of intervention. The need for it arises in the presence of tuberculosis, cysts, tumors localized within one lobe, etc. Such a lung resection can be performed in a minimally invasive way, but the decision should remain with the doctor; reduction. In this case, the removal of non-functioning lung tissue is supposed, due to which the size of the organ is reduced.

According to the intervention technologies, such operations can be divided into two more types. This:

Thoracotomy operation. During its implementation, a wide opening of the chest is performed to perform manipulations. Thoracoscopic surgery. This is a minimally invasive type of intervention in which there is no need to cut the chest, since an endoscope is used.

Separately, the lung transplant operation, which appeared relatively recently, is considered. It is carried out in the most difficult situations, when the patient's lungs stop functioning, and without such intervention, his death will occur.

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Life after surgery

It is difficult to say how long the body will recover after surgery. Many factors influence this. It is especially important that the patient follow the recommendations of the doctor and avoid harmful effects, this will help minimize the consequences.

If only one lung remains

Most often, patients are concerned about the question of whether it is possible to live with one lung. It must be understood that doctors do not make the decision to remove half of the organ unnecessarily. Usually the patient's life depends on it, so this measure is justified.

Modern technologies for the implementation of various interventions allow you to get good results. Human, undergone surgery removal of one lung, can successfully adapt to new conditions. It depends on how correctly the pneumoectomy was performed, as well as on the aggressiveness of the disease.

In some cases, the disease that caused the need for such measures returns, which becomes very dangerous. However, it is safer than trying to save the damaged area, from which the pathology can spread even further.

Another important aspect is that after a lung is removed, a person should visit a specialist for routine checkups.

This allows you to detect a relapse in a timely manner and start treatment in order to prevent similar problems.

In half of the cases after pneumoectomy, people get a disability. This is done so that a person can not overstrain while doing their job duties. But receiving a disability group does not mean that it will be permanent.

After some time, disability can be canceled if the patient's body has recovered. This means that living with one lung is possible. Of course, precautions will be required, but even in this case, a person has a chance to live a long time.

Regarding the life expectancy of a patient who underwent lung surgery, it is difficult to argue. It depends on many circumstances, such as the form of the disease, the timeliness of treatment, the individual endurance of the body, adherence to preventive measures, etc. Sometimes a former patient is able to lead a normal life, practically without limiting himself in anything.

Postoperative Recovery

After an operation on any type of lung has been performed, the patient's respiratory function will be impaired at first, so recovery implies the return of this function to normal. This happens under the supervision of doctors, so the primary rehabilitation after lung surgery involves the patient's stay in the hospital. D

In order for breathing to normalize faster, special procedures, breathing exercises, medications and other measures can be prescribed. All these measures the doctor selects on an individual basis, taking into account the characteristics of each specific case.

A very important part of recovery measures is the nutrition of the patient. It is necessary to clarify with the doctor what you can eat after the operation. Food doesn't have to be heavy. But to restore strength, you need to eat healthy and nutritious food, which is rich in protein and vitamins. This will strengthen the human body and speed up the healing process.

In addition to the fact that proper nutrition is important at the recovery stage, other rules must be observed. This:

Complete rest.
The absence of stressful situations. Avoiding serious physical effort. Implementation of hygiene procedures. Taking prescribed medications. Quit bad habits, especially smoking. Frequent walks in the fresh air.

It is very important not to miss preventive examinations and to inform the doctor about any adverse changes in the body.

nervousness, disturbed sleep and appetite… frequent colds, problems with the bronchi and lungs…. headaches… bad breath, plaque on teeth and tongue… change in body weight… diarrhea, constipation and stomach pain… exacerbation of chronic diseases…

Bondarenko Tatiana

Project expert OPnevmonii.ru

Rehabilitation of patients after radical surgery

Rehabilitation of patients who underwent radical surgery for lung cancer begins in the preoperative period. Patients undergo therapeutic exercises aimed at improving the general condition, the function of external respiration, training in diaphragmatic breathing, sanitation of the tracheobronchial tree, postural drainage, turning techniques in bed, getting up, corrective drug therapy (if necessary), psychotherapy.

Therapeutic respiratory gymnastics is one of the main preoperative measures aimed at sanitizing the trachea and bronchi along with oxygen therapy, anti-inflammatory treatment with inhalations of muco- and bronchodilators, the appointment of cardiac therapy, etc.

Opening the chest cavity is accompanied by the intersection and injury of the intercostal muscles and muscles of the chest, pleura, nerves and blood vessels in the area of operation. Sometimes the phrenic nerve is damaged.

As a result of anatomical disorders and the accompanying pain syndrome, the patient spares the chest during breathing, which sharply weakens its excursion and leads to the development of insufficient pulmonary ventilation.

Therefore, in the postoperative period, in addition to correcting clinical and hemodynamic changes, measures are taken (massage, inhalation, light therapeutic exercises) aimed at preventing postoperative pneumonia, atelectasis, eliminating residual cavities, hemothorax, restoring the drainage function of the tracheobronchial tree.

Operations and diagnostics

Surgery is the main treatment for lung cancer. Patients with stages 1 and 2 of the disease have the best prognosis, while patients with stage 3 have much less chances.

But, judging by the clinical data, doctors operate on only 20% of people with an early form of the disease, and with advanced stages - already 36%. That is, if the patients realized it and were examined immediately, and the doctors recognized oncology in time, then the number of saved lives would be greater.

In the meantime, doctors consider it incredible luck if the patient was able to determine stage 1 lung cancer. In their opinion, with the improvement of diagnostic methods, it will be possible to perform operations on 70% of patients.

Chronic pleural empyema

Sometimes in patients with lung cancer after radical surgery due to infection of the pleural cavity, chronic pleural empyema may develop.

According to pathogenesis, it can be open (supported by broncho-, esophago-pleural or pleuro-cutaneous fistula) and closed (supported by chondritis, osteomyelitis of the ribs, foreign body and microflora resistant to antibacterial agents).

The disease proceeds with alternating periods of exacerbations and remissions and eventually leads to pulmonary heart failure, amyloidosis of internal organs. Treatment of chronic pleural empyema is predominantly surgical. Of the conservative methods of healing bronchial fistulas, local laser therapy with simultaneous sanitation of the bronchial tree is effective.

For lung cancer, radiation therapy is often performed as an independent method, or in combination with surgical or drug treatment. At the same time, acute and chronic radiation damage to the lungs are a frequent complication of radiation therapy.

Uglyanitsa K.N., Lud N.G., Uglyanitsa N.K.

Tumors of the chest wall

In the postoperative period, the main task of the doctor and the patient is to prevent the accumulation of sputum in the lungs. Therefore, the medication prescribed by the doctor is mainly aimed at facilitating coughing. For this purpose, herbal teas, syrups and drugs that have an expectorant effect are used. In bronchitis with impaired patency in the bronchi, drugs are prescribed to expand the bronchus.

special attention requires the treatment of vascular and heart diseases, since they significantly affect the general condition of the body, worsen well-being, preventing the patient from full-fledged physical training.

Almost all patients are prescribed drugs that facilitate the work of the cardiac system in the new conditions. However, any course of treatment should be prescribed and supervised exclusively by the attending physician.

The success of treatment largely depends on the type of neoplasm detected. Depending on the type of cells, doctors distinguish between two types of oncology: small cell and non-small cell lung cancer. The latter accounts for about 80% of cases, while the former is determined only in 20%.

Depending on the condition of the patient, the stage of the disease and metastasis, there are several types of surgical treatment:

Radical: if the germination of metastases has not yet begun, the whole lung is removed to completely remove the tumor site. In this case, the return of oncology after surgery almost does not occur. Radical therapy is not done in the later stages, when extensive tumor growth and metastasis have occurred.
Conditionally radical: surgery is complemented by other methods of treatment (radiation or chemotherapy). The combination of several therapies allows you to suppress cancer cells that have not yet begun to divide. This type of treatment is possible only at stages of the disease that can be corrected.
Palliative treatment is carried out if the patient has had irreversible processes caused by oncology, and there is no chance of recovery. In this case, operations are performed to remove areas of lung tissue that provoke severe pain. Thus, doctors reduce the suffering of patients and in some cases prolong their lives.

It was about the amazing properties of healthy lungs. But, alas, in a diseased organ, everything is far from being the case, and not everyone modern man is the owner of healthy lungs.

Only in Russia today there are about 5 million people with broncho-pulmonary pathology. Their main contingent is residents of large industrial centers and heavy smokers.

It leads among all known malignant tumors, and again in the same contingent - smokers (95% of cancer cases).

All these operations are performed in specialized departments of thoracic (thoracic) surgery by highly qualified specialists.

Tip: often the most dangerous lung diseases, including cancer, can begin with a seemingly harmless cough. It cannot be ignored, it is necessary to consult a doctor and undergo an examination.

All interventions on the lungs can be divided into 2 groups by volume: pulmonectomy or pneumonectomy (complete removal of the lung) and resection (removal of part of the lung). Complete removal is performed in cases of malignant tumors, as well as with multiple pathological foci in all parts of the organ.

Lung resection can be of various sizes:

atypical or marginal - removal of a limited area on the periphery;
segmentectomy - removal of a segment with the corresponding segmental bronchus;
lobectomy - removal of one lobe;
bilobectomy - removal of 2 lobes;
reduction - a decrease in the volume of the lungs when they are affected by emphysema (non-functioning air cavities in the tissue of the organ).

Emphysema of the lungs. a fairly common pathological condition in thoracic surgery.

belongs to the group of chronic obstructive pulmonary diseases. in which the pulmonary vesicles (alveoli) irreversibly overstretch and collapse.

Due to the enzymatic dissolution of the alveolar septa, large bubbles form, in which excess air accumulates. Despite the fact that the lungs are supplied with air, shortness of breath (lack of air) begins.

Thus, the body does not receive enough oxygen, which, under certain circumstances, can adversely affect the internal organs. main reason this disease is smoking, but risk factors such as indoor air pollution, open fires, inhalation of harmful gases and dust in the workplace, as well as possible genetic predisposition and frequent respiratory infections often contribute to the formation of emphysema.

Unfortunately, this disease is incurable, so it is very important to at least stop the progression of the disease. To do this, it is necessary first of all, especially with a progressive disease, to immediately quit smoking, and also try to minimize the impact on the body of other pathogens; an operation to reduce the volume of the lung in such cases is urgent.

During surgery, using the methods of visualized thoracoscopy and minithoracotomy. swollen areas of the lungs are removed, which improves the function of the remaining part of them.

In the most extreme cases, transplantation of the lungs or only one part is possible.

In thoracic surgery, the concept of pyothorax refers to the accumulation of pus in the chest cavity, often due to bacterial inflammation. Treatment consists mainly in the appointment of therapy for basal disease (antibiotics), if necessary, a chest drain is also performed to aspirate purulent contents.

In severe cases, visualized endoscopic cleaning of the empyema is used. To remove the exudate, under the control of visualized methods of thoracic surgery, the pleural cavity is washed and followed by suction again.

If the appropriate treatment is neglected, a pleural mooring (thickening of the pleura) is formed. This condition requires urgent surgical intervention, by means of an open thoracotomy.

Pleural effusion is a widespread syndrome in thoracic surgery, characterized by the accumulation of fluid in the chest cavity. Depending on the type of fluid collected, there are serothorax (clear, yellowish discharge; as a result of heart failure, inflammation or tumor), pyothorax (purulent fluid; mainly with bacterial inflammation), hemothorax (blood; due to injury or damage) and chylothorax (lymph ; as a result of any damage or disturbance of lymphatic drainage).

Tumors and some forms of tuberculosis are considered the most common cause of lung surgery. In case of lung cancer, the operation includes not only the removal of a part or the whole organ, but also the excision of the lymphatic drainage pathways - the intrathoracic lymph nodes. With extensive tumors, resection of the ribs and pericardial sections may be required.

types of operations in the surgical treatment of lung cancer

With the widespread nature of the lesion, massive cancer, disseminated forms of tuberculosis, it is impossible to rid the patient of the pathology by removing only a fragment of the organ, therefore, radical treatment is indicated - pulmonectomy.

If the disease is limited to a lobe or segment of the lung, then it is enough to excise only them.

Traditional open surgeries are performed in cases where the surgeon is forced to remove a large volume of the organ. Recently, they have given way to minimally invasive interventions that allow excising the affected tissue through small incisions - thoracoscopy. Among modern minimally invasive methods of surgical treatment, the use of a laser, an electric knife, and freezing are gaining popularity.

Contraindications for surgery

Removal of the lung can provoke the development of various complications, so it is not indicated for all patients. You can not perform surgery in such cases:

advanced age;
spread of metastases throughout the body;
the presence of severe diseases of the heart and blood vessels, as well as other vital organs;
disorders of the respiratory and circulatory systems;
overweight.

The most aggravating factors of contraindications to surgery for lung cancer are diseases - pulmonary emphysema and cardiovascular pathologies.

Complications and negative consequences

Typical complications in the postoperative period are purulent and septic phenomena, respiratory dysfunction, poor formation of the bronchus stump, fistulas.

The patient, who has come to his senses after anesthesia, experiences a lack of air and, accordingly, dizziness and tachycardia. This condition can persist for up to a year after the operation. Until the connective tissue fills the void at the site of the removed organ, at first a cavity in the chest will be noticeable in the operated area. Over time, it will smooth out, but it will not completely disappear.

Life after surgery

When a part or one lung is removed, anatomical connections are disturbed in the body. This determines all the difficulties of recovery after surgery.

Until the body adapts to new conditions, fills the void of fibrous tissue, it will not be easy for a person to get used to a new way of life. On average, doctors take about two years for rehabilitation, but it goes differently for everyone, depending on the characteristics of the body and the efforts of the patient himself.

Decreased physical activity inevitably leads to weight gain, which is absolutely not allowed, since obesity will increase the load on the respiratory system that has undergone surgery. During rehabilitation, moderate physical activity, breathing exercises are shown to strengthen the respiratory system.

The patient should give up active smoking and beware of passive, follow a special diet.

Surgery for pulmonary oncology is the main method of treatment, which should not be abandoned if there is even the slightest chance to prolong life.

Unfortunately, lung surgeries are most often associated with extremely serious diseases, therefore, they require wide access and a large amount of intervention. Therefore, they are quite traumatic and often end with the removal of the affected area of the lung tissue. In this regard, one of the most important functions, the respiratory function, is disturbed. That's whyrehabilitation after lung surgery this is not an easy task.

However, you should not despair. Of course, the recovery will be long and the patient will have to make a lot of efforts, but the worst and most dangerous is already behind. And systematic work on oneself can significantly improve the well-being and quality of life of such people. Of course, after thelung surgery rehabilitationwill not happen instantly, however, this process will definitely give results with regular practice.

Due to the fact that during the intervention, the lungs and the entire body experience severe stress, after it their function will be reduced, which will lead to chronic oxygen deficiency, which is referred to as hypoxia.

Because of this, the functions of other organs and systems are reduced. The respiratory system itself is also under attack - due to exhaustion and stress, inflammatory processes, traumatic agents and various chemicals, its barrier function is reduced. Therefore, severe postoperative pneumonia often develops. Due to stagnation of blood in the pulmonary vessels, there is a high risk of developing thromboembolic complications.

Early postoperative period

That's why after lung surgerya rehabilitation process should be started as soon as possible, the goal of which is to combat respiratory failure, restore respiratory function and normal expansion of the remaining lung tissue. Already a day after the intervention, patients are seated in bed, and the drainage tube is removed after two to three days. After that, patients can already begin to walk around.

Even simple things like sitting and walking slowly are good exercises to start with. They allow the lungs to breathe deeply, since in this position the diaphragm drops lower. It also improves mucus flow.

Outpatient treatment of patients

Approximately two weeks after the operation, the patient is discharged from the hospital for outpatient treatment. There, he needs to regularly take a chest X-ray and be shown to the local doctor. Thanks to this, his condition will be under constant control. Radiation diagnostics will allow to determine the function and condition of all parts of the lung tissue, and in time to detect a variety of complications and diseases.

The attending physician, focusing on complaints, objective data and the results of instrumental and laboratory studies, will decide on the appointment of physiotherapy procedures, their duration and intensity. However, all patients without exception are recommended special breathing exercises.

Lifestyle changes after lung surgery

Due to the fact that patients after such operations are in conditions of hypoxia of varying degrees, and move away from the intervention, patients are advised to change their living habits in order to help their body recover. Such recommendations include:

To give up smoking.
Refusal to drink alcohol.
Moderate food intake, often diet food.
Sleep normalization.

You should not overload the digestive system with heavy food, as it takes a long time to digest and requires a lot of energy to process. Therefore, patients are asked to give up fatty, floury, smoked, overly peppery and salty foods. They are encouraged to eat moderate amounts of lean meats, fish, vegetables, fruits, and cereals.Nutrition after lung surgery should not be too abundant.

If necessary, you should switch to fractional meals - 5-6 times a day in small portions. This is due to the fact that after anesthesia, the intestines recover for a long time, so such patients are prone to various digestive disorders, flatulence and constipation. That's whynutrition after lung surgery is an important element of rehabilitation.

It should also be taken into account that these patients are very susceptible to infectious diseases of the respiratory system. Moreover, they pose a much more serious threat to them, since their immunity is usually weakened. That's whyrecovery after lung surgeryshould take this factor into account. Patients should avoid drafts, prolonged exposure to cold, damp or stale air.

It is very important that patients also carefully monitor their health and control their well-being. Pay special attention to the level blood pressure and heart health. Indeed, after lung surgery, even a small heart failure can lead to the development of pulmonary edema and deterioration of the patient's well-being. Therefore, patients with arterial hypertension or other chronic heart diseases should visit a cardiologist and regularly take their prescribed medications and control their blood pressure levels.

Gymnastic exercises for patients

Rehabilitation after lung surgeryshould include a set of special exercises that help normalize the drainage of the bronchi and increase ventilation of the lung tissue, thereby increasing blood oxygenation.

Special breathing exercises after lung surgery carried out every day for 3-6 repetitions for several months. The exact duration depends on the condition of the patient, however, it is not recommended to abandon it for good. It is better to simply reduce the intensity - in the future, patients are advised to perform 1-2 repetitions per day for preventive purposes.

Breathing exercises after lung surgery can be started already in the early postoperative period - even with bed rest, patients are advised to take deep, "diaphragmatic" breaths and exhalations, thereby increasing the expansion of the lung tissue. Some doctors recommend bedridden patients to inflate air balloons however, this should be done with caution.

It is also useful to make active movements with arms and legs within the bed. This activates blood flow and unloads the pulmonary circulation, reducing the risk of thrombosis and edema. Patients are shown massage of the chest and back. After the patient begins to stand up, you can begin to perform short 10-minute exercises, eventually moving to 20-minute ones. Patients are advised to roll over on their side and imitate walking with their feet.

The first exercise - hands should be spread apart in such a way that the shoulder blades close as much as possible. In this position, you should perform a series of deep and calm breaths and exhalations. Breathe from your chest, not your stomach.Rehabilitation after lung removal should be under the direction of a physician. At home, patients can exercise on their own, also using light dumbbells and a gymnastic wall.

You can use a gymnastic stick. With straight arms, it should be lifted, holding at its ends and while breathing in. When exhaling, the stick should be lowered. Modification of the exercise - when lifting the stick, turn the body to the side simultaneously with inhalation. You can use the ball. The patient lowers himself, puts the ball on the floor, straightens up and takes a breath. Then repeats in reverse order.

Another exercise - when raising the leg and bending it at the knee, you should inhale, while unbending and lowering to the ground - exhale. Change legs alternately. Thus, the work of several muscle groups is achieved at once, blood circulation and respiration are improved.

Patients interested inhow to recover after lung surgery you can also advise to do the usual daily exercises. This set of exercises is great for “breathing” the lungs, while being free from excessive physical exertion and safe for the heart.

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Classmates

exercises that help the lungs drain up to ten times a day, half an hour before meals and at least an hour after meals;
exercises that activate the reserve capacity of the cardiac and respiratory systems;
simple exercise, but affecting all the muscles of the body;
breathing exercises that use active breathing and hold it for a while;
walks on flat terrain;
moderate stair climbing.

After surgery

During surgery, internal organs are seriously injured. Not only muscles and ribs are damaged, but also nerve endings, which leads to pain after surgery, which, together with depression of the respiratory center, leads to superficial gas exchange, impaired lung drainage. After the operation, other complications also arise - contracture of the shoulder joint of a painful nature, embolism, thrombosis, pneumonia, intestinal atony, problems with the intestines, and others.

Exercise in bed

In the first days, exercises related to diaphragmatic breathing or simply breathing with the diaphragm while lying down. The patient should lie down for one to three days, depending on the severity of the operation.
To develop the cardiovascular system, you need to work with distant limbs - forearms, hands, feet. You can’t get up yet, but in this way you can avoid congestion in the muscles.
From the second day shoulder joints are developed.
Lying on a healthy side, you need to inflate the balloons several times a day.
Massage is prescribed by tapping with fists, vibrating and stroking movements with the palms.
On the second or third day, you can lie on the sore side, and pull your legs to your stomach, lying on your side, imitate walking so that the lungs breathe more actively.

Recovery exercises

On the fourth or fifth day, the patient can exercise in a sitting position, classes should last up to ten minutes.
A week after the operation, you are allowed to walk and exercise for up to 20 minutes. During this period, it is necessary to stimulate trophic (nutritional) processes in tissues, restore posture. The shoulder should move in the same volumes as a healthy one. Breathing should not be diaphragmatic, but chest.
From ten days after the operation. Discharged for 10 - 12 days. You can do it at the gymnastic wall, with light dumbbells, a rubber band. You can also go outside, including walking freely on the stairs.
After a few months you need to play games that promote mobility - badminton, volleyball, table tennis. Recovery in full lasts up to six months, less often - longer.

Indications and types of operations

congenital abnormalities;
lung injury;
the presence of neoplasms (malignant and non-malignant);
pulmonary tuberculosis in severe form;
cysts;
pulmonary infarction;
abscess;
atelectasis;
pleurisy, etc.

Operations that are performed for lung diseases are divided into 2 groups. This:

Lung resection. This type of intervention involves the removal of a part of the lung, the one in which the focus of the pathology is located. Lung resection is of several types. This:

atypical lung resection. Another name for this operation is marginal lung resection. During it, one section of the organ located on the edge is removed;
segmentectomy. Such resection of the lungs is practiced when a separate segment is damaged along with the bronchus. Intervention involves the removal of this area. Most often, when it is carried out, there is no need to cut the chest, and the necessary actions are performed using an endoscope;
lobectomy. This type of operation is practiced when the lung lobe is affected, which has to be removed surgically;
bilobectomy. During this operation, two lobes of the lung are removed;
removal of a lung lobe (or two) is the most common type of intervention. The need for it arises in the presence of tuberculosis, cysts, tumors localized within one lobe, etc. Such a lung resection can be performed in a minimally invasive way, but the decision should remain with the doctor;
reduction. In this case, the removal of non-functioning lung tissue is supposed, due to which the size of the organ is reduced.

According to the intervention technologies, such operations can be divided into two more types. This:

Thoracotomy operation. During its implementation, a wide opening of the chest is performed to perform manipulations.
Thoracoscopic surgery. This is a minimally invasive type of intervention in which there is no need to cut the chest, since an endoscope is used.

If only one lung remains

Modern technologies for the implementation of various interventions allow you to get good results. A person who has undergone an operation to remove one lung can successfully adapt to new conditions. It depends on how correctly the pneumoectomy was performed, as well as on the aggressiveness of the disease.

Another important aspect is that after a lung is removed, a person should visit a specialist for routine checkups.

This allows you to detect a relapse in a timely manner and start treatment in order to prevent similar problems.

Postoperative Recovery

In order for breathing to normalize faster, special procedures, breathing exercises, medications and other measures can be prescribed. All these measures the doctor selects on an individual basis, taking into account the characteristics of each specific case.

In addition to the fact that proper nutrition is important at the recovery stage, other rules must be observed. This:

Complete rest.
The absence of stressful situations.
Avoiding serious physical effort.
Implementation of hygiene procedures.
Taking prescribed medications.
Quit bad habits, especially smoking.
Frequent walks in the fresh air.

It is very important not to miss preventive examinations and to inform the doctor about any adverse changes in the body.

Removal of a lung, its lobe or segment, as a rule, is associated with very serious painful changes in the structure of the lung tissue. It is impossible to leave the affected lung tissue, it poisons the body with tissue decay products, the pathological flora “living” in this area constantly produces toxins and tends to spread beyond the affected area.

The development of pathological changes in the lungs can have a different causality: complications after pneumonia, infections, the specifics of the individual development of the body, heredity, bad habits - you can’t list everything. The disease develops gradually and up to a certain point the body copes with the powerful intoxication that the affected area of the lungs provides, and the breathing volume necessary for life is provided by a healthy, functioning part of the lungs. However, the disease develops and there comes a point when surgery becomes the only means of saving the patient's life.

The operation was performed, the patient's life is out of danger. However, surgery to remove part of the lung is a very difficult intervention. The chest, pleura were dissected, a section of the lung was excised - the interventions are very large-scale and significant for the body. In addition, the patient receives massive drug therapy against the background of a general weakening of the body associated with the course of the underlying disease.

You don't have to be a medical professional to understand that this case a person needs serious and long-term physical rehabilitation, the purpose of which is to restore the quality of life.

What happens after surgery?

The first is a deterioration in the supply of oxygen to the body. Shortness of breath, weakness increases, headache, chest pain, heart problems, and heart rate may become more frequent. It must be understood that all these problems are associated with a decrease in the size of the lung after surgery - a void has formed in the chest.

The formation of empty space inside the chest seriously affects the state of the body. It leads to a change in the habitual ratios of intracavitary pressures in the macrocavities of the body that have developed during the growth and development of the body: the pelvic cavity, the abdominal cavity, the chest as a cavity, as well as to a change in the existing spatial arrangement of organs. Syntopy and skeletotopy of organs are changing, that is, the location of organs relative to other organs and relative to the skeleton. Abdominal organs: stomach, intestines and organs located in the chest: lungs, heart, aorta, esophagus begin to shift and these spatial structure disorders further aggravate the patient's condition, leading to malfunctions in other body systems due to changes in the conditions of blood supply and innervation of organs - tension or compression of nerve trunks and vascular bundles.

Another problem after surgery is pleural adhesions and others. Adhesions limit changes in the linear dimensions of the remaining parts of the lungs, thereby reducing tidal volumes. Residual intoxication is also a problem after the operation - the affected part of the lung is removed and no longer poisons the body, however, the lung is a sponge in its structure and a large amount of unnecessary waste products remain in its pores that need to be drained. remove from the body.

Is it possible to help the body adapt more quickly and more fully after such a serious surgical intervention?

What rehabilitation tasks should be solved during the implementation of the rehabilitation program?

The first task is to “breathe” the remaining parts of the lungs and drain, clean them out using special active drainage techniques.

The second task is to help the body in the process of spatial restructuring. It is necessary to actively form the statics and dynamics of the body, as well as the balance of pressures in the macro cavities of the body.

The third task is to restore lung displacement, for this it is necessary to eliminate adhesions, but not by surgery, but again with the help of physical rehabilitation methods, that is, with the help of special exercises!

All these tasks are successfully solved in our clinic.

It must be said that we do not accept everyone for rehabilitation!

Admission for treatment is carried out after consultation with our specialists.

1. Pulmonary tuberculosis.

3. Diseases accompanied by copious sputum.

4. Purulent diseases: lung abscess, pleural empyema.

5. Acute pneumonia.

7. Fevers of unknown origin.

To conduct a gymnastics course, patients with diseases of the respiratory system must pass a general blood test, sputum analysis (if it is separated), undergo a fluorography (or an overview of the chest).

Bronchial asthma is a chronic inflammatory and allergic disease of the respiratory tract associated with increased reactivity of the bronchi and a tendency to spasm, narrowing of their lumen. As well as the accumulation of thick viscous sputum in them. The disease is caused by specific - allergies, sensitization to plant pollen, animal hair, house dust and other allergens, and non-specific - harmful environmental factors (smoke, various gases, aerosols and mineral dust) mechanisms. The development of the disease is facilitated by a genetic predisposition, certain environmental conditions. The disease is manifested by difficulty breathing, dry wheezing and periodic attacks of suffocation that occur upon contact with the allergen, physical activity, exposure to cold air, against the background of respiratory viral infections. The course of bronchial asthma is different types: mild intermittent, persistent, moderate and severe with the development of respiratory failure. Treatment of bronchial asthma includes an integrated approach - avoidance of contact with allergens, drug inhalation (bronchodilator and anti-inflammatory) therapy. Importance In the management of patients with asthma, there are rehabilitation measures (physiotherapy exercises, breathing exercises, homeopathic method) aimed at improving the quality and life expectancy of a person suffering from asthma.

Chronic obstructive pulmonary disease (COPD).

This is a disease of the upper and lower respiratory tract of an inflammatory and steadily progressive nature, which is based on the difficulty and restriction of air entry into the respiratory tract, due to the constant irritation of the lung tissue by various harmful microparticles, mineral dust, cigarette smoke, hot air, high humidity. The disease is manifested by a constant cough, with expectoration of mucopurulent or purulent sputum, wheezing in the lungs, shortness of breath when walking and other physical exertion. In the future, it leads to the development of emphysema, pneumosclerosis of respiratory failure and gradual disability of the patient. The main method of treatment is anti-inflammatory therapy and the rejection of exposure to harmful factors. An important role is played by non-drug methods of influence (homeopathy, herbal medicine) and rehabilitation measures: physiotherapy exercises and breathing exercises; which increase the vital capacity of the lungs, increase the drainage of stagnant sputum and reduce the further progression of the inflammatory process in the lung tissue.

Acute lobar or focal pneumonia is one of the most common diseases of a bacterial nature, characterized by severe intoxication, fever, cough and shortness of breath. It occurs against the background of a respiratory infection, chronic bronchitis, obstructive pulmonary diseases, under conditions of a decrease in the body's defenses, the presence of concomitant chronic diseases, increased physical activity, smoking. It is caused by various bacterial agents that are normally present in the lumen of the bronchi on the mucous membrane, but under conditions of decreased immunity become pathogenic (that is, they can cause inflammation of the lung tissue). In the acute stage of the disease, inflammatory exudate accumulates in the lumen of the alveoli and at this stage antibiotic therapy is carried out; an increase in the volume of movements of the chest and an increase in the vital capacity of the lungs. A set of specially designed exercises on therapeutic simulators leads to an increase in the drainage function of the lungs, an increase in ventilation and blood supply to the lung tissue, as a result of which the process of resorption of the inflammatory focus is accelerated and the risk of developing complications of acute pneumonia (focal pneumosclerosis, pleurodiaphragmatic adhesions, lung abscess, respiratory failure).

In our clinic, there is the possibility of using complex methods of exposure for all of the listed diseases: exercise therapy according to the original author's method on special simulators under the supervision and direct guidance of the author of the method and experienced exercise therapy instructors, massage, homeopathic treatment. As a result of regular exercises, the tone of the muscles of the chest increases, the vital capacity of the lungs increases. the discharge of stagnant sputum improves, as a result of which the lumen of the bronchi expands, the frequency and intensity of asthma attacks decrease, which makes it possible to subsequently reduce the dose of inhaled drugs and begin to breathe freely.