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Thoracic Surgery: Meaning, Scope, and Other Details

Team AckoJan 18, 2024

Thoracic Surgery, as a critical pillar of medical practice, encompasses the diagnosis, treatment, and management of a wide spectrum of chest disorders. This specialised field is devoted to addressing the intricate structures situated within the thoracic cavity, which include the heart, lungs, oesophagus, and major blood vessels. In this article, we will explore the world of Thoracic Surgery. Let's dive in.

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Contents

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What is Thoracic Surgery?

Thoracic Surgery is a specialty of medicine that focuses on the treatment of chest-related illnesses and disorders. Thoracic surgeons are highly competent physicians who specialise in the diagnosis and surgical treatment of problems affecting these essential structures. Thoracic Surgery's major purpose is to enhance a patient's health and quality of life by treating chest diseases. 

Lung cancer, collapsed lungs, tumours, infections, congenital anomalies, and esophageal illnesses are examples of such ailments. Often, thoracic surgeons collaborate with other medical specialists, including radiologists and oncologists, to correctly diagnose problems and devise treatment regimens. They evaluate each patient's unique circumstances and recommend the best surgical technique or combination of therapies, ensuring the best potential outcome.

What are the common types of Thoracic Surgery?

Here are some of the common types of Thoracic Surgery.

  1. Lung Resection includes removing a piece of the lung that has been impacted by disorders such as lung cancer, infections, or nodules. Wedge resection, segmentectomy, lobectomy, and pneumonectomy are all forms of lung resection.

  2. Coronary artery bypass grafting (CABG) is a form of Thoracic Surgery used to treat coronary artery disease (CAD). CAD develops when the blood passages that deliver oxygen and nutrients to the heart muscle, known as coronary arteries, become constricted or obstructed owing to plaque formation.

  3. Thoracoscopy, or video-assisted thoracoscopic surgery (VATS), is a minimally invasive method that visualises and operates on the chest cavity using tiny incisions and a camera. It is utilised for lung biopsies, pleural effusion therapy, and the identification of certain lung diseases.

  4. Lobectomy is the surgical removal of a complete lung lobe. 

  5. Esophagectomy involves the removal of all or part of the food pipe (oesophagus), usually for the treatment of esophageal cancer or severe esophageal conditions. The remaining healthy part of the oesophagus is then reconnected to the stomach or a portion of the small intestine.

  6. Chest Wall Resection and Reconstruction is a  procedure used to remove tumours or repair abnormalities in the chest wall caused by trauma, infections, or certain malignancies.

Surgical techniques used for Thoracic Surgery

Thoracic Surgery includes many procedures depending on the specific condition being treated.

  • Open surgery: This includes creating a bigger incision in the chest to provide access to the thoracic cavity. It enables broad surgical interventions and difficult treatments by providing direct visibility and access to the region.

  • Minimally Invasive Surgery (MIS): Minimally invasive procedures are gaining traction as surgeons tilt towards conservative approaches. They minimise incision size, less discomfort, faster recovery, and better cosmetic outcomes. MIS is usually done via Video-assisted Thoracoscopic Surgery and Robotic-Assisted Thoracic Surgery.

Pre-surgery considerations

Thoracic surgeries are major surgeries and need critical planning.

  • A thorough examination of the patient's general health and particular problem is required before Thoracic Surgery. This examination determines if the patient is a good candidate for surgery and examines the risks and potential benefits. 

  • Doctors review the medical history, including previous operations, allergies, and any underlying health concerns. 

  • A physical exam is conducted to evaluate the patient's overall health, lung function, and cardiovascular fitness. This helps assess their tolerance for surgery and anaesthesia. 

  • Blood tests, electrocardiograms (ECGs), chest X-rays, and lung function tests may be performed to acquire further information about the patient's health.

How to prepare for Thoracic Surgery

Here is a guide to help you get ready.

  1. Schedule a meeting with your thoracic surgeon. They will review your case and may also perform a physical examination and order additional tests or imaging to assess your overall health and the specific condition needing surgery.

  2. Make sure to follow the instructions given by your surgical team. Your surgeon will let you know which medications to continue or stop before surgery.  You'll be asked to avoid eating or drinking for a certain period before surgery. If you smoke, it's strongly advised to quit before surgery. 

  3. Surgery can be emotionally challenging. Don't hesitate to ask your surgeon any questions or share any concerns you have about the procedure or recovery process. Having a clear understanding will help ease your worries.

  4. Talk to friends, family, or support groups about your feelings and fears. Sharing your emotions can provide comfort and reassurance during this time. Enlist the help of a family member or friend who can assist you with everyday tasks like cooking, cleaning, and managing medications during your recovery period.

  5. Your surgeon will instruct you and prepare any recommended supplies or equipment in advance, like compression stockings or mobility aids.

Recovery after Thoracic Surgery

Do’s:

  • Stick to the post-operative care plan provided by your healthcare team. This includes taking medications as prescribed, following wound care instructions, and attending follow-up appointments.

  • Keep the incision site clean and dry as per the instructions provided.

  • Take pain medications as prescribed by your healthcare team to control post-operative pain.

  • Take a balanced diet to fasten healing.

  • Take rest and gradually increase physical activity. Begin with gentle activity, such as short walks, as your healthcare team advises.

Don'ts:

  • Don't ignore severe pain or pain that grows with each passing day.

  • Don't force yourself into sudden strenuous activities.

  • Don't ignore follow-up appointments.

Frequently Asked Questions (FAQs)

Here are some frequently asked questions on Thoracic Surgery.

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What conditions can be treated with Thoracic Surgery?

Thoracic Surgery is used to treat a range of conditions involving the organs and structures within the chest. Some common conditions include lung cancer, esophageal cancer, mediastinal tumours, emphysema, pneumothorax (collapsed lung), thoracic outlet syndrome, chest wall deformities, and diseases of the heart and major blood vessels.

Will I have scars after Thoracic Surgery?

The appearance of scars following Thoracic Surgery depends on the type of procedure performed. Traditional open surgeries usually involve larger incisions, which can leave more noticeable scars. On the other hand, minimally invasive techniques like VATS or robotic-assisted surgery use smaller incisions, resulting in smaller scars that are often less visible. The scars often resolve with time.

How can I prepare for Thoracic Surgery?

A doctor will evaluate your vitals, and medical history and give you X-rays/CTs /MRIs to prepare a proper plan. You will need to follow instructions throughout the surgery phases. A doctor will guide you on what to do and what to avoid.

Are there any risks or complications associated with Thoracic Surgery?

Risks such as infection, bleeding, blood clots, damage to surrounding structures, adverse reactions to anaesthesia, and complications specific to the operated organ (e.g., air leaks after lung surgery) are possible. The healthcare team will discuss the potential risks and complications with the patient before the surgery and take appropriate measures to minimise them.

How long does it take to recover from Thoracic Surgery?

Minimally invasive procedures like VATS or robotic-assisted surgery generally have shorter recovery times compared to traditional open surgeries. In general, patients may spend a few days to a week in the hospital, followed by several weeks to a few months of gradual recovery at home. The healthcare team will provide specific post-operative care instructions and guidelines for a successful recovery.

Resources 

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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