Specialized medical services

The Respiratory Center was opened at Osaka University Hospital in April 2012. Presently at many medical institutions, respiratory diseases that are medical conditions are treated by respiratory medicine, and those that are surgical conditions are treated by general thoracic surgery, but depending on the disease it is not uncommon that multidisciplinary diagnosis and treatment that combines radiological diagnosis and treatment with medicine and surgery is required. The Respiratory Center was established at Osaka University Hospital to perform patient-centered treatment in recognition of the need for close cooperation across clinical sections. In the past, the best course of treatment for each patient was determined by a joint review session including Respiratory Medicine, Thoracic Surgery and Radiology, but now patients can be moved quickly and properly from diagnosis to treatment by unification in one hospital ward. In addition, nurses and physical therapists with training and specialized knowledge of nursing and rehabilitation for patients with respiratory disease also contribute to treatment. The Respiratory Center provides the following treatments.

Lung cancer:

In the treatment of lung cancer, indications for surgery, chemotherapy or radiation therapy are determined depending on the stage of progression. Multidisciplinary treatment combining these is required by many patients.

Diffuse pulmonary disease:

Pathological diagnosis by diagnostic imaging, bronchoscopic biopsy or thoracoscopic biopsy is performed to decide on the course of treatment.

Pneumothorax:

Rest, thoracic drainage, thoracoscopic surgery or other treatment is conducted depending on medical condition.

Metastatic lung tumors:

For lung metastasis of malignant tumors of other organs, the indication for surgery is determined from the medical condition.

Mediastinal disease:

Thoracoscopic surgery is performed for benign mediastinal tumors, while a multidisciplinary approach combining chemotherapy and radiation therapy is used for malignant mediastinal tumors. Thymectomy for myasthenia gravis is performed in principle by thoracoscopic surgery.

Lung transplant-related diseases:

Lung diseases presenting with respiratory failure (such as interstitial pneumonia, emphysema, pulmonary hypertension, pulmonary lymphangioleiomyomatosis, bronchiectasis) are diagnosed and the indication for lung transplant is assessed. In addition, patients are hospitalized for regular examination after lung transplant.

Features

Totally endoscopic surgery by thoracoscope is used in principle for surgical treatment of pneumothorax, early lung cancer and metastatic lung tumors. The minimally invasive surgery performed is easy on the patient's body while securing complete curability. Postoperative management is conducted in the Respiratory Center's recovery room equipped with state-of-the-art equipment.
This facility is among the most experienced in the country in treating mediastinal tumors such as thymoma and thymic carcinoma. Multidisciplinary treatment, including chemotherapy and radiation therapy, can be conducted for advanced cases.
Thymectomy, the established treatment for myasthenia gravis, is in principle conducted by thoracoscopy.

The staging of lung cancer is the most important process in determining the course of treatment. Optimal treatment based on proper staging can be provided by using diagnostic imaging by high performance multi-slice CT, PET-CT or MRI scans, along with endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) as skilled respiratory medicine, or surgical mediastinoscopy.
For lung cancer, the presence or absence of gene mutations is investigated, and individual treatment optimized for each patient is provided, considering the stage of progression and histological type. The center is also actively engaged in multicenter collaborative research, and the most advanced treatments can be offered after they have passed ethical review.
Respiratory rehabilitation is provided for perioperative patients and chronic obstructive pulmonary disease patients by a joint respiratory rehabilitation team from Respiratory Medicine, Department of Nursing and Rehabilitation.

Considerations in referring your patients to Respiratory Center

For consultation, please contact the Patient Support Center of our hospital in advance, and bring a letter of referral from your current clinic or hospital.

Links to General Thoracic Surgery and Respiratory Medicine

• General Thoracic Surgery http://www.thoracic.med.osaka-u.ac.jp/jp/
• Respiratory Medicine http://www.imed3.med.osaka-u.ac.jp/index.html