TürkçeLung diseases are the general name for medical conditions that affect the respiratory system by impairing oxygen intake and carbon dioxide removal and may develop as a result of infection, inflammation, genetic predisposition, or environmental factors. Asthma, COPD, pneumonia, bronchitis, and lung cancer are among the most common lung diseases, and early diagnosis plays an important role in preserving respiratory functions.
The symptoms of chronic lung diseases usually appear as a long-lasting cough, shortness of breath, sputum production, chest tightness, and reduced exercise capacity. Smoking, air pollution, and occupational chemical exposure increase the risk of developing these diseases and may cause permanent damage to the respiratory tract.
Diseases caused by lung infections develop when microorganisms originating from bacteria, viruses, or fungi affect lung tissue. Infections such as pneumonia and acute bronchitis may present with fever, chills, productive cough, and chest pain. In individuals with weakened immune systems, the disease may progress to a more severe clinical picture.
Treatment methods for lung diseases are planned according to the type and severity of the disease and the patient’s general health condition. Drug therapy, bronchodilators, antibiotics, inhaled corticosteroids, and oxygen support are among the commonly used approaches. In addition, smoking cessation, pulmonary rehabilitation, and regular medical follow-up increase treatment success.
| What You Need to Know | Information |
| COPD (Chronic Obstructive Pulmonary Disease) | Includes conditions such as chronic bronchitis and emphysema. Narrowing of the airways and air trapping occur. |
| COPD Symptoms | Shortness of breath, chronic cough, sputum production, difficulty breathing during exercise. |
| COPD Treatment | Smoking cessation, bronchodilator medications, inhaled corticosteroids, oxygen therapy, pulmonary rehabilitation. |
| Asthma | It is a disease characterized by chronic inflammation of the airways in the lungs. It is usually allergic in origin. |
| Asthma Symptoms | Wheezing, shortness of breath, chest tightness, cough, especially at night. |
| Asthma Treatment | Avoiding triggers, inhaled bronchodilators, inhaled corticosteroids, allergy treatment. |
| Pneumonia | It is an infection of the lung tissue caused by bacteria, viruses, or fungi. |
| Pneumonia Symptoms | High fever, cough, sometimes with sputum, chest pain, shortness of breath, fatigue. |
| Pneumonia Treatment | Antibiotic, antiviral, or antifungal medications depending on the cause; supportive fluid and oxygen therapy. |
| Tuberculosis | It is a contagious lung disease caused by the bacterium Mycobacterium tuberculosis. |
| Tuberculosis Symptoms | Persistent cough, night sweats, weight loss, bloody sputum, fatigue. |
| Tuberculosis Treatment | Long-term antibiotic treatment, usually 6 months, and isolation measures. |
| Pulmonary Embolism | It is the blockage of the blood vessels in the lungs by a clot; it usually results from deep vein thrombosis in the legs. |
| Pulmonary Embolism Symptoms | Sudden shortness of breath, chest pain, tachycardia, fainting, cough. |
| Pulmonary Embolism Treatment | Anticoagulant medications, thrombolytic treatment, and surgical intervention in severe cases. |
| Lung Cancer | It develops through uncontrolled cell growth in lung tissue; smoking is the primary risk factor. |
| Lung Cancer Symptoms | Persistent cough, bloody sputum, weight loss, shortness of breath, chest pain. |
| Lung Cancer Treatment | Surgery, chemotherapy, radiotherapy, targeted therapies, immunotherapies. |
| Pulmonary Fibrosis | It is a progressive disease characterized by thickening and stiffening of lung tissue. |
| Pulmonary Fibrosis Symptoms | Dry cough, progressive shortness of breath, fatigue, clubbing of the fingers. |
| Pulmonary Fibrosis Treatment | Antifibrotic medications, oxygen support, and lung transplantation may be required in some advanced cases. |
| Bronchiectasis | It is the permanent widening and inflammation of the bronchi and creates a tendency toward infections. |
| Bronchiectasis Symptoms | Chronic cough, sputum, recurrent lung infections, shortness of breath. |
| Bronchiectasis Treatment | Respiratory physiotherapy, antibiotics, bronchodilators, regular sputum clearance. |
What Are Lung Diseases and What Is the General Anatomical Structure?
The lungs are vital organs with a spongy structure located on the right and left sides of the chest cavity. While the right lung consists of three large sections, called lobes, the left lung consists of two lobes to make room for the heart. When we breathe, air passes through the trachea into the main bronchi and then spreads into increasingly smaller airways. Blockages, inflammation, tumors, or fluid accumulation in the membranes at any point in this remarkable system may lead to various diseases. The most important factor that brings success in treating these diseases is identifying where in the anatomical tree the problem began. Thoracic surgery deals not only with lung tissue itself but also with the membranes surrounding it, the diaphragm muscle that enables us to breathe, the bones forming the chest wall, and the lymph nodes located in the space around the heart. This broad field of practice requires providing treatment through a holistic approach to the patient.
Some commonly encountered lung problems are:
- Lung cancers
- Collapsed lung
- Inflammation of the pleura
- Fluid accumulation in the chest cavity
- Widening of the airways
- Advanced emphysema
What Is Lung Cancer and What Are Its Early-Stage Symptoms?
Lung cancer develops when the genetic structure of the cells lining the respiratory tract becomes damaged and these cells multiply uncontrollably. Under normal conditions, the body’s immune system recognizes and destroys these abnormal cells, but cancer cells somehow manage to escape this defense mechanism and gradually grow to form masses, namely tumors. Cancer is divided into small cell and non-small cell groups according to the type of cell from which it originates. The most insidious aspect of the disease is that there are no pain nerves within lung tissue. Therefore, a person may not feel any pain until the tumor grows considerably and places pressure on the membranes, chest wall, or airways. This situation demonstrates the importance of early diagnosis and the necessity of regular health screenings. The earlier the disease is detected, before it has spread to other tissues, the greater the chance that it can be completely removed through surgical intervention and the patient can regain health.
Some symptoms that may be seen in the early stages of the disease are:
- Persistent cough
- Bloody sputum
- Shortness of breath
- Chest pain
- Hoarseness
- Loss of appetite
What Are the Minimally Invasive Methods Used in Lung Cancer Surgery?
In the past, when lung surgery was mentioned, the first thing that came to mind was a very large incision made through the side of the rib cage and the separation of the ribs using special instruments to perform the operation. These traditional open operations, called thoracotomy, meant a highly painful recovery process for patients. Today, however, minimally invasive surgical methods known as Video-Assisted Thoracoscopic Surgery, or VATS, have become standard. In this method, small openings only one or a few centimeters wide are made between the ribs. A thin, rod-shaped camera that projects the inside of the chest cavity onto a high-resolution screen is inserted through one of these openings. Specially designed, thin, and long instruments used to perform the surgical procedures are inserted through the other openings. Because the ribs are not stretched during these operations performed while viewing a screen, muscle and nerve damage is minimized. Patients experience much less pain after surgery, their hospital stay is shortened, and returning to normal life takes only days instead of weeks.
What Are the Differences Between Robotic Surgery and Traditional Lung Surgery?
The highest level of minimally invasive surgery is robotic surgery. In these operations, where advanced systems such as Da Vinci are used, the surgeon sits at a special console inside the operating room rather than standing beside the patient. The robotic arms placed inside the patient’s chest cavity transfer the surgeon’s finger movements precisely and perfectly to the instruments inside the patient. The instruments used in traditional minimally invasive surgery resemble straight rods and have limited maneuverability. However, the mechanisms at the tips of robotic arms can perform far more movements than the human wrist and rotate 540 degrees. The camera system shows the interior to the surgeon in three dimensions, with depth perception and magnification of up to 15 times. In this way, diseased tissues around the heart, major vessels, and vital nerves can be removed with millimetric precision.
The advantages offered by robotic surgery are as follows:
- Three-dimensional imaging
- High maneuverability
- Tremor prevention technology
- Low risk of bleeding
- Rapid discharge
- Aesthetic healing
What Types of Surgery Are Performed According to the Size of a Lung Tumor?
The surgical removal of a tumor from the lung is called resection. The amount of tissue to be removed is carefully determined entirely according to the tumor’s diameter, location, and the patient’s respiratory capacity. The aim is always to remove the cancerous tissue without leaving any diseased cells behind while preserving as much healthy lung tissue as possible. If the tumor is relatively large and located close to the center of a lung lobe, the entire lobe must be removed, and this procedure is called lobectomy. This is currently the most commonly performed standard method. However, if the tumor is much smaller and has been detected at an early stage, only the smaller anatomical section containing the tumor is removed instead of the entire lobe. This procedure is called segmentectomy.
The criteria determining the type of surgery are:
- Tumor diameter
- Tumor location
- Lymph node involvement
- Patient’s age
- Pulmonary function tests
What Are the Correct Diagnostic Methods for Lung Diseases?
The most important step in successful treatment is knowing exactly what the disease is and how far it has spread throughout the body, in other words, its stage. There are many lymph nodes in the chest cavity, especially around the trachea and heart. These lymph nodes act like security checkpoints because they filter fluid from the cells in the lungs. When a tumor in the lung begins to spread, its first destination is usually these lymph nodes. Therefore, it is not enough to see only the lesion inside the lung; it is also necessary to prove at the cellular level whether these lymph nodes are free of disease. Imaging methods such as computed tomography or PET scans show us only suspicious areas. For a definitive diagnosis, it is essential to take a tissue or cell sample from those suspicious areas and examine it under a microscope. At this stage, highly specialized and delicate methods used by surgeons for tissue sampling come into play.
The tests used during diagnosis are:
- Computed tomography
- PET scan
- Pulmonary function test
- Blood tests
- Sputum examination
What Are the Differences Between Mediastinoscopy and EBUS?
There are two main methods used to obtain samples from lymph nodes. The first is mediastinoscopy, which has been considered the gold standard for many years. This procedure is performed in an operating room under general anesthesia. Through a very small incision made in the lower part of the neck, a lighted tube equipped with a camera is advanced toward the front of the trachea, and tissue samples are directly cut and removed from the lymph nodes in this region. The other modern method is EBUS, meaning endobronchial ultrasound-guided bronchoscopy. In this method, no incision is required. The patient is given a mild sedative, and a special tube with an ultrasound device at its tip is inserted through the mouth into the trachea. Thanks to ultrasound, lymph nodes hidden behind the airways are visualized, and cells are aspirated from within these nodes using a very thin needle.
The main differences between the two methods are:
- Presence of an incision
- Type of anesthesia
- Type of sample obtained
- Areas reached
What Are Pleural Diseases?
There is a very thin, shiny, and slippery two-layered membrane structure called the pleura that covers the outer surface of the lungs and the inner surface of the rib cage. Normally, there are only a few drops of special fluid between these two membrane layers. This fluid allows the lungs to glide smoothly within the rib cage without friction while we breathe. At the same time, there is negative pressure, a kind of vacuum effect, between these two membranes. Thanks to this vacuum, when our rib cage expands, the lungs follow and expand, filling with air. However, if air enters between these two membranes from outside due to various diseases or trauma, or if excessive fluid is produced and accumulates inside, this delicate vacuum system is disrupted. The lung cannot find enough space to expand and begins to collapse. This condition presents with sudden severe shortness of breath, a stabbing sensation, and chest pain.
What Causes a Collapsed Lung (Pneumothorax) and What Are Its Symptoms?
A collapsed lung, medically called pneumothorax, is a condition in which air suddenly fills the space between the pleural membranes. Imagine a deflated balloon that cannot inflate because of pressure surrounding it; similarly, the lung becomes trapped within the chest cavity. This condition may sometimes occur as a result of trauma such as a severe traffic accident, a fall from height, or rib fracture. However, more interesting are the cases that occur completely spontaneously without any impact. Small air-filled blisters that are congenital or develop over time may exist at the very top of the lungs. When these thin-walled blisters suddenly rupture one day, air from within the lung escapes between the membranes. These spontaneous ruptures are particularly common in young, tall, thin individuals who smoke. If the disease is mild, it may improve with rest and oxygen alone. However, if the amount of collapse is extensive, a plastic tube must be inserted through the chest wall to remove the accumulated air and allow the lung to reinflate.
Risk factors for the development of pneumothorax are:
- Smoking
- Tall and thin body structure
- Young male sex
- Emphysema
- Chest trauma
What Causes Fluid Accumulation in the Lungs (Pleural Effusion)?
Just as air may accumulate, liters of fluid may sometimes collect between these two membranes. This is called pleural effusion. The problem occurs when the balance between the small amount of fluid normally produced and reabsorbed by the membranes is disrupted. There may be many different causes of fluid accumulation in the body. In a patient with heart failure, fluid leaking into the pleural space because the blood cannot be pumped effectively is a very common cause. In addition, lung infections, pneumonia, tuberculosis, or unfortunately lung cancer and cancers that have spread from other organs may also cause fluid accumulation in this space. The accumulated fluid presses on the lung like a water-filled cushion and makes it impossible for the patient to breathe. Treatment primarily aims to drain this fluid using a needle or tube and relieve the patient. If the fluid is caused by cancer and repeatedly returns, safe substances such as talc powder are introduced between the membranes to make them adhere to each other and improve the patient’s quality of life.
Conditions that cause fluid accumulation are:
- Heart failure
- Lung cancer
- Pneumonia
- Tuberculosis
- Kidney failure
Is Excessive Sweating (Hyperhidrosis) a Thoracic Surgery Condition?
Although it is not widely known in society, excessive sweating of the hands, underarms, or face that makes a person’s life extremely difficult is one of the conditions successfully treated by thoracic surgery. This condition, called hyperhidrosis, is not natural sweating associated with hot weather or physical exertion. The problem is caused entirely by a communication error within the involuntary sympathetic nervous system. The sympathetic nerves continuously send the command to sweat glands to “sweat,” like a malfunctioning thermostat. These patients avoid shaking hands in social settings, soak papers while holding a pen, and have to change clothes constantly. This condition, which may also cause psychological problems, often cannot be resolved with simple creams or temporary injections. At this point, surgical intervention on the main nerve pathway that passes through the rib cage and controls the sweat glands provides a definitive and permanent solution.
To Which Areas Is Minimally Invasive Sweating Surgery (ETS) Applied?
Endoscopic Thoracic Sympathectomy, or ETS surgery, which is the definitive treatment for excessive sweating, is a highly comfortable procedure performed entirely through a minimally invasive technique. While patients are asleep under general anesthesia, a tiny one-centimeter opening is made in the armpit, and a camera is inserted. The sympathetic nerve chain, which extends like a cable along the back wall of the rib cage immediately beside the spine, is located. The surgeon identifies the target section responsible for sweating and interrupts the signal by placing small titanium clips on that part of the nerve. The greatest advantage of the clipping method is that if bothersome compensatory sweating begins in another part of the body in the future, the clips can be removed, offering the possibility of reversing the procedure. The results of the operation are remarkably rapid. While the patient is still on the operating table, hands that have been sweating heavily for years become dry and warm within seconds.
The areas where the operation is most successful are:
- Palms
- Underarms
- Face
- Scalp
What Are Mediastinal Diseases and Thymus Tumors?
The highly important space located in the center of the rib cage between the right and left lungs and containing the heart, major vessels, esophagus, and trachea is called the mediastinum. This region is like the busiest intersection in the body, and masses or tumors that arise there carry the risk of pressing on the vital organs immediately beside them. One of the most notable structures in this region is the thymus gland. The thymus is an organ that plays a role in the development of the immune system but shrinks and largely loses its function in adulthood. However, sometimes the cells of this gland become uncontrolled and develop into tumors called thymomas. Interestingly, many patients with these tumors also have a neurological disease that causes severe muscle fatigue and weakness. Treatment requires complete removal of the tumorous thymus gland. Today, thanks to robotic surgery technology, this gland can be completely removed through only three small openings without the need to cut the sternum lengthwise as in the past.
Common problems in the mediastinal region are:
- Thymus gland tumors
- Lymphoma masses
- Congenital cysts
- Extension of goiter into the chest cavity
- Nerve sheath tumors
What Are Chest Wall Deformities?
Our rib cage is not only a fixed shield that protects our internal organs but also a flexible and mobile bone-cartilage system that enables us to breathe. However, in some children, excessive and disproportionate growth occurs, especially in the cartilage sections where the ribs join the sternum, due to congenital genetic programming. This condition becomes most noticeable during adolescence, when rapid height growth occurs. This abnormal growth in the cartilage distorts the shape of the sternum and leads to two main deformities. These disorders should not be regarded merely as cosmetic problems. In advanced cases, the bony structure that collapses inward or protrudes excessively outward places pressure on the heart and lungs immediately beneath it and prevents them from working at full capacity. These patients tire much more quickly than their peers, become breathless during exercise, and feel pain in their chest. In addition to physical problems, particularly among adolescents, serious psychological trauma such as embarrassment about body appearance and social withdrawal may also occur.
The most common types of deformity are:
- Funnel chest
- Pigeon chest
- Asymmetrical chest wall
What Are the Treatments for Funnel Chest and Pigeon Chest?
Funnel chest, known as pectus excavatum, is a condition in which the sternum is sunken inward toward the heart. Pigeon chest, known as pectus carinatum, is a condition in which the bone protrudes outward. In the past, very extensive operations were performed to correct these deformities by completely opening the rib cage, cutting the cartilage, and reshaping it. Today, however, this approach has changed completely. In the treatment of funnel chest, a remarkable minimally invasive operation called the Nuss procedure is performed. A steel or titanium bar specially bent according to the patient’s body is inserted through small openings made on both sides of the rib cage. This bar is passed directly behind the sternum and rotated around itself, instantly pushing the sternum outward as if using a jack. The bars remain in the body for several years so the bone structure can permanently harden in its new position and are then removed with a simple procedure. In pigeon chest, special braces that apply external pressure are highly effective in the early period, while in advanced cases, minimally invasive correction operations using bars are also successfully performed.
The treatment methods used are:
- Nuss procedure
- Abramson procedure
- Vacuum bell treatment
- Orthotic use
What Are Diaphragm Diseases and Hernias?
The parachute-shaped, flat, broad muscle layer separating our rib cage from the abdominal cavity is called the diaphragm. When we inhale, this muscle contracts downward, expanding the chest cavity and allowing air to fill the lungs. If the nerves that enable this vital muscle to function are damaged for any reason, diaphragmatic paralysis occurs. The paralyzed muscle relaxes, cannot withstand pressure from the abdominal organs, and rises like a tent into the chest cavity, compressing the lung from above. This condition causes very severe shortness of breath. Another important diaphragm problem is hernias. Through congenital weak points in the diaphragm or tears caused by severe traffic accidents, abdominal organs such as the stomach or intestines may move into the chest cavity. The treatment of both conditions is surgical. In paralysis, the relaxed muscle is folded and sutured to tighten it, while in a hernia, the organs are returned to their proper location and the torn area is repaired.
Common diaphragm problems are:
- Diaphragmatic paralysis
- Congenital hernias
- Traumatic tears
- Diaphragm tumors
What Is Bronchiectasis and What Are Its Surgical Treatments?
Bronchiectasis is the permanent destruction, loss of elasticity, and abnormal widening of the airways inside the lungs, namely the bronchi, due to recurrent severe infections or serious childhood diseases. These widened airways can no longer clean themselves. Sputum constantly accumulates inside, creating an ideal breeding environment for bacteria, and the patient experiences repeated severe lung infections in a vicious cycle. Patients generally complain of producing large amounts of foul-smelling sputum and occasional coughing up of blood. The priority in treatment is always to keep the condition under control with powerful medications, expectorants, and breathing exercises. However, if the disease is confined to only one specific area of the lung and the patient’s quality of life has deteriorated to the point of requiring repeated hospitalization despite medication, surgically removing the severely damaged part of the lung provides complete recovery.
Conditions requiring surgery are:
- The disease being confined to one region
- Frequently recurrent pneumonia
- Uncontrollable bleeding
- Abscess formation
- Insufficient response to medication
What Are the Surgical Solutions for Patients with COPD and Advanced Emphysema?
At the foundation of COPD and emphysema, which are very common in society, lies the loss of elasticity of the air sacs at the farthest ends of the lungs, causing them to rupture and merge into enormous, useless air spaces. Like an old rubber band that has lost its elasticity, these areas cannot expel the air that fills them. The rib cage remains constantly inflated, flattening the diaphragm and making it impossible for the patient to breathe. A highly specialized surgical method has been developed for patients with advanced emphysema: lung volume reduction surgery. The logic of this operation is very simple; since these enormous swollen areas serve no purpose and also compress the healthy lung tissue, they are cut out and removed. Once the nonfunctional sections are removed, the pressure inside the rib cage immediately decreases, the diaphragm muscle relaxes, and the compressed healthy lung tissue opens up and begins functioning.
The benefits provided by this surgery are:
- Increased respiratory capacity
- Improved exercise tolerance
- Improved diaphragm function
- Improved quality of life
Frequently Asked Questions
Prof. Dr. Alper Fındıkcıoğlu graduated from Istanbul University Faculty of Medicine and completed his thoracic surgery residency at Dr. Siyami Ersek Hospital. He began his academic career at Başkent University in 2005; he received the title of associate professor in 2014 and professor in 2022. He has extensive experience in lung cancer, chest wall diseases, and minimally invasive surgery. Since 2024, he has been continuing his professional work at Acıbadem Hospital.
