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Pneumology

Pneumology is the medical specialty that deals with respiratory disease, addressing not only diagnosis and treatment but also any necessary preventive activities. It deals with very common processes such as respiratory infections, bronchial asthma, acute and chronic bronchitis, pulmonary emphysema, pulmonary tuberculosis and lung cancer. Similarly, it also includes diagnosis and treatment of respiratory disorders associated with sleep (sleep apnea). Its basic purpose is to study, diagnose, treat, prevent and rehabilitate patients suffering from respiratory diseases.

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Meanwhile, Thoracic Surgery is a relatively modern specialty, directly related to Pneumology, that deals with the diagnosis and surgical treatment of chest diseases affecting the chest wall, pleura, lungs, trachea and bronchi, mediastinum, esophagus and diaphragm.

At Hospitales San Roque in Las Palmas de Gran Canaria, our service offers a comprehensive assessment of respiratory  disease with doctors specialized in this area, and also performs diagnostic procedures and early and combined treatment, based on the use of pulmonary function tests, videobronchoscopy, Minimally Invasive Surgery-- Video-Assisted Thorascopic Surgery-- and open surgery with short-term hospitalization.

As far as respiratory disease, we offer the following consultations:

  • Chronic bronchitis or tobacco smoke-induced emphysema COPD.  Monitoring and early diagnosis both through medical consultation and through lung function tests and bronchodilator therapy are very important, and emphasizes should be placed on quitting smoking and, in advanced cases, oxygen therapy.
  • Bronchial asthma.  Includes both children and adults.  Allergic or extrinsic asthma is very prevalent in the Canaries, where dust mite play an important role.  Moreover, asthma is particularly important on our islands due to characteristic weather phenomenon such as haze, which causes frequent relapses.  Also, there is a high correlation between allergic rhinitis and asthma in these patients.
  • Diagnosis of lung tumors.  Lung cancer is currently the most common neoplasm and the most common cause of death from malignant tumors, accounting for 28% of cancer deaths and 6% of all deaths.  With these data, it is not difficult to justify the efforts required in order to prevent it (antismoking consultations) and offer quick and early lung cancer diagnosis.
  • Respiratory infections.  Lung infections in children and adults, both bacterial or viral upper respiratory infections-- rinosinusitis, laryngitis, croup, etc.--, and lower respiratory tract infections--bronquitis, pneumonia, etc.-- are another group of diseases dealt with in Pneumology, and are especially common during the autumn-winter season.
  • Sleep Medicine  Here an assessment is made of patients with suspected sleep apnea syndrome, mainly big snorers who are usually obese and complain of daytime drowsiness.  These symptoms limit the patient's life, with reduced physical and mental performance and, therefore, lower job performance, and a higher risk of diseases such as hypertension and ischemic heart disease.  Thus, early diagnosis and appropriate treatment based mainly on nocturnal non-invasive ventilation (CPAP) and health education offer important benefits for these patients.  Alternative therapies such as mandibular prosthesis or uvulofaringoplastia should also be considered.  Our service has a team of expert neurophysiology with ample experience in performing the most common test for this pathology: polysomnography.
  • Chest trauma and its complications.  Evaluation and treatment of rib fractures, sternum fractures, haemo-pneumothorax trauma, etc.
  • Pleural effusion  Infectious or malignant origin, this is a common ailment that usually requires combined diagnosis and treatment.
  • Pneumothorax.  Spontaneous, traumatic or iatrogenic origin, it is a very common condition for our specialists.  If treated initially with minimally invasive surgery, it is possible to reduce the chance of recurrences.
  • Others.  There are a number of conditions that must be evaluated by Pneumologyist and Specialists in Thoracic Surgery.  Worth noting among these are interstitial lung disease, pulmonary vascular diseases, including pulmonary embolism, pulmonary hypertension, vasculitis, occupational diseases, work-related and environment, etc.
  • Smoking Cessation Unit  Smoking is becoming more and more prevalent among increasingly young citizens, and smoking cessation programs are one of the key services pneumologist offer their patients.  Tobacco consumption is the leading preventable cause of death in Spain: each year 55,000 people die in our country because of it.

 

This unit uses the latest diagnostic and therapeutic advances in order to help patients quit smoking, offering strict monitoring-- including by telephone-- throughout the treatment in order to achieve the final objective of quitting smoking.  Having a doctor intervene in smoking cessation significantly increases the rate of abandonment of tobacco, which is virtually nil without medical assistance.  We also offer a comprehensive consultation with a specialized psychologist and an endocrinological valuation if necessary in order to help control the patient's weight.

 

Sweat Pathology Unit  Excessive palmar, axillary, axilo-palmar or craniofacial sweating or hyperhidrosis is a frequent complaint.  The ultimate solution could be botulinum toxin or minimally invasive surgery (thoracic sympathectomy), a state-of-the-art technique that is available through our Service.

 

One of the techniques and procedures we use is Minimally Invasive Surgery, which allows us to deal with:

  • Surgical treatment of excessive sweating of the cranium and face, hands and armpits and facial flush.  It is performed on an outpatient basis under general anesthesia and with a single 1-cm incision in each hemithorax.  The patient leaves the operating room without drainage.
  • Surgical treatment of pneumothorax.  It is performed under general anesthesia and with 2 to 3 1-cm incisions in the corresponding hemithorax.
  • Bullectomy and lung volume reduction surgery for pulmonary emphysema patients who smoke. Performed under general anesthesia and with three 1-cm incisions.
  • Surgical resection of mediastinal tumors.  Performed under general anesthesia and with three 1-cm incisions.
  • Thymectomy (removal of the thymus) in patients with myasthenia gravis or thymic tumors.
  • Lung biopsies to diagnose lung disease.  Performed under local anesthetic and sedation and with a single 1-cm incision.  May also include instilling talc inside the pleural cavity in order to avoid the appearance of pleural effusions.
  • Lung biopsies in order to diagnose intrapulmonary disease.   Performed under general anesthesia and with 2 to 3 1-cm incisions.
  • Video-thoracoscopic correction of pectus excavatum (sunken chest) by inserting a custom-made steel bar below the sternum under general anesthesia and through 2 small incisions in each hemithorax.  This technique requires epidural catheter to prevent pain following the surgery.

 

On the other hand, some common open surgery procedures include:

  • Removal of pulmonary metastases (presence of tumoral cells from tumors originating elsewhere) in patients whose primary tumor is under control.  Performed under general anesthesia and submammary thoracotomy with hidden incision.
  • Pulmonary surgical resection such as lobectomy (excision of a lung lobe) or pneumonectomy (excision of the entire lung) in malignant lung tumors.  Performed through less painful amniotic incisions or by inserting a epidural catheter in order to prevent pain.  Accompanied by excision of all mediastinal lymph nodes (lymphadenectomy).
  • Stabilizing the chest wall through fractures or flail chest in trauma patients with respiratory failure.
  • Cardiopulmonary cleaning and decortication for pleural cavity infections (empyema).
  • Removal of mediastinal tumors (between the lungs).
  • Tracheal repair surgery in patients with tracheal tumors or stenosis.
  • Intrathoracic thyroid surgery (intrathoracic goiter).

 

Non-Invasive diagnostic tests:

  • Spirometry and flow-volume curves, with particular emphasis on the patient's pre and post-surgery assessment.
  • Bronchodilation test for patients being studied for suspected bronchial asthma.
  • Respiratory allergy studies: hypersensitivity skin tests (prick-test) used primarily to study allergic or extrinsic asthma, RAST.
  • Plethysmography and measurement of static lung volumes with inert gases.
  • Alveolar-capillary diffusion tests.
  • Chest Ultrasound: Study of complex pleural effusion, pulmonary mass valuation, etc.
  • Pathophysiological studies using exhaled nitric oxide, a state-of-the-art technique for early diagnosis that is not available in other medical centers on the island.
  • Respiratory stress test.
  • Analysis of respiratory gases in arterial and venous blood.
  • Polysomnography, cardiorespiratory polygraphy and continuous measure pulse oximetry for assessment in-hospital and at home.
  • Capnography.
  • Induced sputum.
  • Cooximetry to control smoking cessation.

 

Invasive diagnostic tests:

  • Diagnostic and therapeutic thoracentesis.
  • Flexible bronchoscopy and complementary techniques: bronchial and transbronchial biopsy without fluoroscopic guidance, Wang needle transbronchial aspiration, bronchioaspiration, bronchial brushing and bronchoalveolar lavage.
  • Closed or transcutaneous lung biopsy.
  • Pleuroscopy (thoracoscopy).

 

Non-invasive therapeutic techniques:

  • Aerosole treatments.
  • Parenteral antibiotic treatments.
  • Specific immunotherapy (vaccines).
  • Respiratory rehabilitation and physiotherapy techniques.
  • Non-invasive ventilation treatments.

 

Invasive therapeutic techniques:

  • Pleural drainage.
  • Intrapleural fibrinolysis for infected pleural effusions.
  • Rigid bronchoscopy and complementary techniques: endobronchial brachytherapy, endobronchial cryotherapy, endobronchial laser therapy, endobronchial electrocautery, endobronchial photodynamic treatments, placement of endobronchial prosthesis, removal of foreign bodies.

Consultations of this specialty are most frequently related to smoking cessation, chronic coughing, Chronic Obstructive Pulmonary Disease (COPD), bronchial asthma, sleep apnoea and lung cancer.

In the Hospitales San Roque en Maspalomas and Care Center Vecindario, Pneumology service we boast the technology and equipment necessary to perform functional tests such as arterial blood gas tests, spirometry, bronchodilation tests and home overnight respiratory polygraphy.

We also perform some invasive tests such as diagnostic and evacuating thoracocentesis for pleural effusion and bronchoscopy for airway assessment, diagnosis of lung cancer and infectious diseases among others.

Other tests carried out are: sputum culture, determination of allergies. Likewise, we have a wonderful radiology service equipped with the equipment required for chest x-rays, chest computed tomography (chest CT), angio-CT for the diagnosis of pulmonary thromboembolism and high resolution computed tomography (HRCT) among others, which are crucial in the diagnosis and treatment of respiratory diseases.

The objectives of the Pneumology consultation of our hospital are:

  • To design and take part in strategies for the prevention of respiratory diseases.
  • Individualised care, under the principle that “it’s not the disease that counts, only the sick person".
  • To establish a smooth relationship with patients, family members and colleagues based on professionalism, commitment, trust and respect.
  • To apply the best diagnosis and treatment techniques for each and every patient.

In keeping with our policy of providing excellent health care for the largest possible part of the population, Hospitales San Roque has added a new specialty to its portfolio at the Care Center Néstor de la Torre, in the residential, commercial and tourist center of Las Palmas de Gran Canaria.

The Pneumology Service offers a comprehensive assessment of respiratory disease including evaluation by medical specialists in this area and early diagnostic and therapeutic procedures, supported always by the physicians and technicians at our center in Vegueta in order to guarantee full coverage and the highest possible quality. 

Consultations of this specialty are most frequently related to smoking cessation, chronic coughing, Chronic Obstructive Pulmonary Disease (COPD), bronchial asthma, sleep apnoea and lung cancer.

In the Hospitales San Roque en Maspalomas and Care Center Vecindario, Pneumology service we boast the technology and equipment necessary to perform functional tests such as arterial blood gas tests, spirometry, bronchodilation tests and home overnight respiratory polygraphy.

We also perform some invasive tests such as diagnostic and evacuating thoracocentesis for pleural effusion and bronchoscopy for airway assessment, diagnosis of lung cancer and infectious diseases among others.

Other tests carried out are: sputum culture, determination of allergies. Likewise, we have a wonderful radiology service equipped with the equipment required for chest x-rays, chest computed tomography (chest CT), angio-CT for the diagnosis of pulmonary thromboembolism and high resolution computed tomography (HRCT) among others, which are crucial in the diagnosis and treatment of respiratory diseases.

The objectives of the Pneumology consultation of our hospital are:

  • To design and take part in strategies for the prevention of respiratory diseases.
  • Individualised care, under the principle that “it’s not the disease that counts, only the sick person".
  • To establish a smooth relationship with patients, family members and colleagues based on professionalism, commitment, trust and respect.
  • To apply the best diagnosis and treatment techniques for each and every patient.
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