Thoracic Surgery: Understanding Its Role in Treating Chest Conditions

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Pain, pressure, or tightness that originates in or radiates to your chest could indicate an underlying issue requiring thoracic surgery. Also known as cardiothoracic surgery, this medical specialty involves operating on the heart, lungs, and major blood vessels within your chest cavity.

Thoracic surgeons in the United States are highly trained through various competitive pathways. They perform open and minimally invasive surgical procedures, including the following.

Lung Cancer

Depending on the type of cancer, lung cancer treatment may include chemotherapy, radiation therapy, or surgery. Some thoracic surgeons like Armen Parajian are experts at treating lung tumors through minimally invasive techniques, like video-assisted thoracic surgery (VATS).

During VATS lung cancer surgery, the doctor makes several cuts over your chest and then inserts a thoracoscope tube into one of these incisions with a camera. The thoracoscope gives the surgeon clear, detailed images of your chest and lung area to guide them as they operate.

The surgical technique has been credited with significantly reducing the length of hospital stays for patients who undergo this procedure and those who receive thoracic cancer screening. The shorter stays are also associated with improved clinical outcomes and lower costs. Surgical advances and enhanced recovery procedures have opened the door to treating older, frailer, and sicker patients previously considered inoperable for this type of cancer. This is a remarkable change in treatment for these patients, who are more likely to have co-morbidities.

Lung Tumors

In recent years, doctors have been able to treat more and more people with lung cancer thanks to advances in surgery, enhanced recovery, and improved screening. This has significantly improved the chances of a cure, especially for early-stage non-small cell lung cancer (NSCLC).

To diagnose NSCLC, your doctor will perform diagnostic tests to determine how big the tumor is and whether it’s spread. Then, your doctor will decide whether or not you need surgery.

If your tumor is small and in an area that doesn’t affect your breathing, your doctor may do a lung lobectomy, which removes the part of your lung with a cancerous tumor. They might also do a wedge or segmentectomy, which removes a smaller section of your lung. They might also take out lymph nodes in the area of the tumor. These small immune system glands trap viruses and bacteria and are one of the first places cancer spreads to.

Lung Cirrhosis

Thoracic surgeons perform operations on organs in the chest, including the lungs, esophagus, and trachea. They remove tumors, diagnose diseases, and repair lungs damaged by disease or trauma.

A thoracic surgeon may use imaging and tests that measure how well your lungs work to determine what surgery is needed. They might also order a surgical biopsy to get tissue samples to help make a diagnosis.

Most thoracic surgery is done under general anesthesia, which means you’ll sleep through the operation. Your provider may cut through your breastbone or between ribs (thoracotomy) to reach the area they need to operate on.

Minimally invasive thoracic surgery includes video-assisted thoracoscopic surgery, which involves inserting a long, thin tube with a camera and surgical instruments through two or three small incisions between your ribs. The surgeon views the procedure on high-resolution monitors in the operating room. They control the instruments from a console that converts their hand, wrist, and finger movements into movements of the tools inserted in your chest.

Lung Transplantation

The lung transplantation treatment is a way to replace your diseased lung and breathe more comfortably. During surgery, your doctor exposes your lungs by splitting your breastbone (sternum) into two sections and spreading them open to gain access to the lungs. They then remove your native diseased lung and connect the donated lungs to oxygen-rich blood vessels.

Your healthcare provider may also place thin silicone tubes into your chest to drain blood, fluid, and air. The tubes are called catheters. They also let your healthcare provider monitor your heart rate, blood pressure, and breathing during recovery.

You will likely remain in the hospital until your new lung is fully expanded with oxygen. You must take medication to prevent rejection, which is when your immune system recognizes the donor lung as a foreign object and tries to destroy it. Your healthcare providers will prescribe immunosuppressants to prevent this from happening. It’s important to balance activity periods with rest and to increase your activity level as you heal gradually.

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