May 24, 2021
Challenging Surgery Case in Pandemic
A 29-year-old patient who was diagnosed with PAP, a rare disease at DY Patil Hospital, we succeeded in saving the life of a 29-year-old man from Dombivali who was suffering from pulmonary alveolar proteinosis (PAP), a rare disease, by conducting the first whole lung lavage procedure.
The patient, Anuj, a 29-year-old from Dombivali had developed breathlessness and was referred to DY Patil Hospital, Navi Mumbai by Dr. Sandhya Kulkarni in mid-January. The patient was investigated by Dr. Abhay Uppe, a senior consultant pulmonologist, patient was diagnosed with PAP.
Dr. Abhay Uppe informed, “We diagnosed that Anuj was suffering from pulmonary alveolar proteinosis (PAP) through lung biopsy. PAP is a very rare condition with an incidence of 1-2 per 10 lakhs population and this condition is usually undiagnosed or diagnosed at a very late stage. The only proven treatment option for it is whole lung lavage (Washing the lung from inside with warm saline).”
Dr. Uppe further said, “Initially the parents of Anuj refused to go for the treatment as they felt the procedure was big and they were also worried. However, on January 31, 2021, Anuj’s condition worsened and his blood oxygen started falling. He was admitted to DY Patil Hospital, Navi Mumbai in the department of pulmonary medicine. After being counseled by me and Dr. Girija Nair (Head of pulmonary medicine), the patient and his parents agreed to the procedure. This was a very challenging case, especially considering the age of the patient. The procedure for such type of disease usually takes 6-8 hours under general anesthesia. This was the first time in Navi Mumbai that such the whole lung lavage was being performed.”
“Our pulmonary faculty Dr. Prem Maurya, Dr. Abhijeet Ahuja and Dr. Shahid Patel were well versed with the procedure. The procedure which was done on February 1, 2021, consisted of a pulmonologist, anesthetist and physiotherapist. The lung was washed with 18 liters of warm saline and the entire procedure lasted for 7.5 hours. A special kind of anesthesia was given by our anesthetist Dr. Mayur Ganvir in which only one lung is ventilated while another lung is washed with saline. Dr. Titiksha Pol gave physiotherapy during the procedure,” informed Dr. Uppe.
“Patient is stable now and was discharged in just seven days,” added Dr. Uppe.