Thoracic Surgery

What is Thoracic
Surgery?
Thoracic surgery is the field of medicine involved in the surgical treatment of diseases affecting organs inside the chest (the thorax).
Esophagus (Muscular tube that passes food to the stomach)
Trachea (windpipe)
Chest wall
Lung
What are the main diseases affecting these organs and treated by
thoracic surgery?
Pleural disease
- Definitions
- Pleural effusion: Fluid in the pleural cavity (between the lung and the chest wall) It could be benign, malignant, empyema or bloody (hemothorax)
- Pneumothorax: Benign disorder defined by free air in the pleural cavity ( Lung collapse due to air leak from small spontaneous opening of the lung tissue)
- Symptoms
- Difficulty in breathing, chest pain
- Treatments
- Insertion of small tubes and/or minimally invasive video-assisted surgery through very small incisions
Lung nodule / cancer
- Definitions
- Lung nodule: Small rounded or irregular opacity seen in thoracic imaging which is smaller than 3 cm
- Lung cancer: Growth of abnormal cells in the lung, can invade surrounding tissues and spread to other parts of the body
- Symptoms
- Incidental finding or respiratory symptoms such difficulty in breathing, chest pain, bloody sputum, voice changes, hoarseness, repeated lung infections
- Treatments
- Minimally invasive video-assisted surgery through very small incisions, open thoracotomy, multidisciplinary treatment with chemo/radiotherapy if needed
Chest wall
- Definitions
- Trauma: blunt or sharp trauma may cause single or multiple rib fractures, tear in the lung, fracture in the vertebra and sternum
- Congenital deformity: Pigeon chest, Funnel chest, sternal cleft are the most frequent chest wall disorders that cause cosmetic and physiologic disturbances in the patients body
- Symptoms
- Shortness of breath, chest pain, decrease in exercising capacity
- Treatments
- VATS Nuss bar operation, plating the fractured ribs or sternum
Mediastinal disease
- Definitions
- Myastenia Gravis: Neurologic disease that effects the nerves and muscles. Thymus gland in the mediastinum is the main target for treatments.
- Tumors: Primary masses that are located between the vital structures in the chest
- Mediastinal lymph nodes: They are present in every healthy human but their enlargement may indicate diseases of malignant or infectious cause
- Symptoms
- Generalised weakness, shortness of breath, swelling in the face, abnormal vessels of the skin in the upper body, chest pain, swallowing difficulties
- Treatments
- VATS Thymectomy, Surgical resection of the tumors for treatment, biopsy for diagnosis, Mediastinoscopy, EBUS
Tracheal (Windpipe) disease
- Definitions
- Stenotic tumors of the trachea, thyroid tumors invading the trachea
- Access to the major airway: need for tracheostomy
- Symptoms
- Stridor, shortness of breath, bloody sputum when coughing, dependence on the mechanical ventilator
- Treatments
- Resection and end-to-end anastomosis, stenting, endobronchial therapy, tracheostomy
Excessive sweating / Local hyperhidrosis
- Definitions
- Excessive sweating is especially in palms and axilla and not triggered by a rise in temperature or physical activity.
- Symptoms
- Wet palms and axilla
- Treatments
- ETS (endoscopic thoracic sympathectomy) operation for palmar and axillary hyperhidrosis
Diaphragmatic disorders
- Definitions
- Diaphragm paralysis/ eventration is the term for one sided failure of this structure
- Herniation of abdominal organs into the chest through openings in the diaphragm
- Symptoms
- Difficulty of breathing, palpitation
- Treatments
- Plication of the diaphragm by surgery, closure of the opening by surgery
Lung transplantation
- Definitions
- Replacing single or both lungs with donor lungs. The existing lungs are irreversibly damaged or lost its functions.
- Symptoms
- Shortness of breath, decrease in exercise capacity
- Treatments
- Surgical removal of diseased lungs and transplanting lung from donors
What are the main diseases affecting these organs and treated by thoracic surgery?
Asthma can’t be cured, but its symptoms can be controlled. Because asthma often changes over time, it’s important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.
The key to living with asthma successfully is to keep it under control. Limit contact with asthma triggers in your environment, monitor your condition with a peak flow meter, and follow your treatment plan strictly.
Work on reducing asthma triggers. A first step is to stop smoking and protect yourself second-hand smoke in your home and in public places.
It is possible to be active and stay healthy when you’re living with asthma. In fact, many medal-winning Olympic athletes have asthma. Exercise strengthens your respiratory muscles, helps maintain weight.Exercises that are less likely to trigger asthma symptoms include swimming, walking, hiking, and leisurely biking. Sports that have short bursts of activity are also less likely to set off symptoms. Examples include baseball, football, and sprinting.
You may have to pace yourself at times or make some adjustments here or there, such as avoiding outdoor sports in the early morning, when pollen counts are at their highest (assuming pollen is one of your triggers).
Stress can be a trigger for asthma attacks. With that in mind, commit to implementing stress-reduction strategies into your life, such as breathing exercises, meditation, and other tactics.
Stay mindful of your emotional state. People with asthma may be more likely to develop anxiety or depression. If you begin to feel down or depressed, talk with your doctor. Help is available.
Asthma presents a number of day-to-day challenges that need to be overcome. Take steps to make it easier for you to commit to these
Simply checking and recording peak flows once per day could make a big difference in your asthma control. A low number can indicate you may be headed toward an asthma attack.
Learn how to use your medications correctly. Find out all you can about your asthma medicine, including how and when to take it, potential side effects, and how it controls your asthma. If you use a metered dose inhaler, learn how to use it properly.
Talk to your doctor about adjusting your routine if compliance is becoming an issue or you are experiencing side effects.
Not having your rescue inhaler immediately available can be dangerous. Because you have no idea when you might need it, consider keeping a spare in your backpack, purse, desk, or any place Even people who take their asthma medicine exactly as prescribed and who work to avoid triggers can have the occasional asthma attack. It's essential to have an asthma action plan in place for those times. This will include symptoms to look for, actions to take, danger signs, avoiding triggers, medication instructions, and when to call your doctor or go to the emergency room.
What are the diagnostic techniques for the thoracic disease?
CT scan
Chest MRI
Video-assisted thoracoscopic surgery
Endobronchial ultrasound
Navigational bronchoscopy
Endoscopic ultrasound

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