Introduction
Thoracic surgery is a term that is used interchangeably with cardiothoracic surgery. Cardiothoracic surgery is a highly specialized discipline dedicated to treating a wide range of thoracic diseases. This involves any procedure to the chest area, between the neck and the abdomen.
In this article, we will go over thoracic surgery in detail, including the advancements it has made and the conditions that necessitate surgical intervention in the chest, as well as the contemporary less intrusive methods used in the surgeries.
In the past…
Thoracic surgery was formerly centered on TB and bronchiectasis surgery. Since 1940, however, significant progress has been made in surgery treating lung cancer and esophageal cancer. Following 1960, cardiac surgery emerged as a distinct field with an emphasis on coronary bypass surgery, valve surgery, and congenital heart surgery.
Nowadays…
In the last two decades, thoracic surgery has developed considerably. Multidisciplinary therapy is becoming increasingly prevalent, and surgeons have key collaborative roles in the treatment of lung cancer, respiratory infections, chest traumas, and end-stage respiratory failure.
An in-depth understanding of chest wall anatomy is paramount to those performing any surgical procedure of the chest. The entire spectrum includes surgery of the heart, lungs, pleura, esophagus, and thymus gland, as well as surgery of the chest wall, mediastinum, and diaphragm (the muscle that divides the chest from the abdomen).
Thoracic surgery necessitates a thorough understanding of physiology, imaging, organ function tests, investigation, pre-operative evaluation, post-operative and critical care, trauma, malignancy, and transplantation. It also includes multidisciplinary treatment procedure experience.
A Thoracic Surgeon is a medical specialist who specializes in surgical operations involving the heart, lungs, esophagus, and other chest organs. This group includes cardiac surgeons, general thoracic surgeons, and congenital heart surgeons. A thoracic surgeon's primary competency is the pre-, intra-, and post-operative treatment of patients with general thoracic surgical disorders. This involves investigating patients, making treatment decisions, performing technically correct treatments, and providing professional post-operative care.
Thoracic surgery indications
Thoracic surgery includes surgery for both benign disorders such as chest infections or esophageal problems, as well as excision of tumors or cancers of the chest.
On the one hand, cancer surgery accounts for about 80% of thoracic surgery. Lung cancer, esophageal cancer, chest wall tumors, and malignancies of the mediastinum are all examples of this. Cancers of the chest can be surgically removed using the traditional method, which involves making large incisions or using the less invasive VATS method.
Lung cancer is the most common reason for thoracic surgery nowadays. The traditional surgical methods for lung cancer include lobectomy and, to a lesser degree, pneumonectomy. Recent advancements in thoracic surgery, on the other hand, have concentrated on parenchyma-saving methods such sublobar resection. These approaches eliminate the necessity for pneumonectomy, resulting in reduced impact on pulmonary function and, as a consequence, a higher quality of life, particularly in patients who cannot tolerate pneumonectomy.
Fortunately, patients with tumors that spread to the lung from other sites often still have a chance to be cured by surgical removal of these metastatic lung tumors, frequently in combination with chemotherapy.
Thoracic surgeons, on the other hand, can treat a wide range of non-cancer disorders, such as
They include both benign, congenital conditions such as pectus excavatum as well as removal of cysts and tumors
Minimally invasive procedures
Video-assisted thoracic surgery (VATS) and robot-assisted surgeries are examples of sophisticated minimally invasive techniques that a well-trained thoracic surgeon can utilize. These approaches result in less blood loss, less postoperative pain, a shorter hospital stay and a quicker recovery and return to normal activities.
Robotic surgery is an extension of the minimally invasive surgical method, offering a three-dimensional view and permitting precise operational interventions through small incisions utilizing sophisticated devices that imitate human wrists. The surgeon works at a console, where controls transform the surgeon's hand, wrist, and finger movements into motions of the instruments inserted in the chest. Robotic surgery can effectively perform thymectomy for Myasthenia Gravis and removal of small anterior mediastinal tumors.
Note!
Many elderly and critically sick patients can now get surgical treatment that they would not have been able to tolerate with a traditional open surgical technique thanks to minimally invasive techniques.
Conclusion
Thoracic Surgery provides comprehensive care to patients suffering from disorders of the chest's structures and organs, including the lungs, heart, and esophagus. Less invasive surgical methods, such as VATS and robotic surgery, have been utilized, increasing the success rate of the operation and lowering the possibility of complications. It is normal to be concerned about thoracic surgery, but your surgeon is prepared to work with you and assist you through the procedure.
