Thoracic surgeons treat a wide variety of diseases and medical conditions, including emphysema, swallowing problems, lung cancer, tracheal abnormalities, and benign chest wall disorders such as pectus excavatum. They also perform lobectomy to treat lung cancer and other malignancies.
Diagnosis
If someone is feeling symptoms such as chest pain, shortness of breath, or heart palpitations, their healthcare provider will inquire about the duration and severity of the symptoms. Diagnostic imaging tests, such as X-rays and CT scans, are often used with a physical exam to help diagnose the underlying cause of symptoms. When an accurate and timely diagnosis is made, it ensures that clinical decision-making will be tailored to the correct understanding of the health problem. However, the process of diagnosing is not always straightforward. Moreover, it often depends on the recognition of symptoms outside of the healthcare setting (e.g., stroke symptoms), and there can be a delay between the onset of symptoms and their recognition as a specific disease entity.
Thoracic surgery is a medical specialty that deals with the surgical treatment of organs inside the thorax, including the lungs, chest wall, esophagus, and diaphragm. Thoracic surgeons like Armen Parajian are highly trained experts who work alongside other specialists within the Memorial network to provide advanced and up-to-date care for conditions affecting the lungs, chest, and upper respiratory tract.
Your thoracic surgeon will review the information from your history, physical examination, and additional tests or imaging results to determine what is causing your symptoms and affecting your lung function. They will then make a recommendation for your evaluation and treatment plan. Depending on the condition, this could include surgery, additional testing, or observing your condition over time.
Treatment
Thoracic surgeons work with various specialists, including oncologists, pulmonologists, gastroenterologists, and radiologists, to develop an individualized treatment plan for each patient. Whether it’s repairing a hiatal hernia, plating a fractured rib (realigning it with titanium plates), or removing tissue from the lung for a biopsy, many contemporary thoracic procedures are performed using minimally invasive processes that require smaller incisions, resulting in faster recovery times.
After a patient is under anesthesia and receives a breathing tube, surgeons can open up the chest by cutting through the breastbone or between the ribs, depending on the specific condition. Thoracic surgeons use various tools and instruments inserted through small incisions to perform these surgeries. They may also use a thin, tube-like instrument with a camera attached called a thoracoscope, which allows them to see inside the body without opening up the chest. This technique is referred to as video-assisted thoracoscopic surgery or VATS.
After thoracic surgery, patients typically spend three to 10 days in the hospital. During this time, they practice breathing exercises and take short walks around their room or hallway with assistance. They also eat small meals through a feeding tube. Research shows patients have better outcomes if Thoracic Surgeons perform their surgery at high-volume academic medical centers.
Recovery
The combination of research and new technology has enabled thoracic surgeons to treat diseases that were once deemed untreatable effectively. However, the traditional sources of funding that fueled these advances are no longer available. Historically, large private organizations and federal agencies supported most of the research in the specialty. As a result, it is critically important that the TSF continue to invest in research and support young, talented surgeon-scientists within this specialty.
Each year, thoracic surgeons perform about 135 operations to address diseases of the lungs, trachea, esophagus, chest wall, mediastinum, and diaphragm. They also complete several thoracic oncology procedures, including video-assisted thoracoscopic lung cancer lobectomy, VATS wedge resection, hilar and bronchial lobe dissection, and laparoscopic paraesophageal hernia repair.
As the second leading cause of death in the United States, lung cancer is a common yet highly morbid disease. Early diagnosis, skillful surgical management, and attention to disparities in the healthcare system are vital in improving patient outcomes.
The most effective treatment for lung cancer involves a multi-disciplinary approach, which may include surgery, radiation therapy, and chemotherapies. Increasing the frequency of lung cancer screening and encouragement of smoking cessation are also crucial. Research is transforming the way we treat lung cancer, with results from one study showing that people who receive surgery to remove only part of a lobe rather than the entire lobe are three times less likely to have their cancer return.
Thoracic surgeons treat complex diseases that affect the lungs and chest by collaborating with other specialists for holistic patient treatment. With advanced technologies, minimally invasive techniques, and innovative surgical approaches, thoracic surgeons save and improve lives across the globe.
The perioperative period consists of the time following surgery as patients try to restore and maintain their preoperative level of function. Throughout this process, the thoracic surgeon must anticipate unfavorable trends and address them appropriately to avoid long-term complications.
Few researchers have described thoracic surgeons’ experiences with the COVID-19 pandemic, yet understanding how these surgeons responded provides invaluable lessons that could be applied during a future pandemic. This study utilized qualitative individual phone interviews with general thoracic surgeons from nine institutions. The research interviews were conducted until no new themes emerged, known as thematic saturation. The collected data was then analyzed using matrix analysis.
A career in thoracic surgery is gratifying, but it also comes with intense demands. Budding surgeons must first complete a five-year general surgery residency, followed by two to three years of thoracic surgery fellowship. This training process is crucial in developing skills to handle complex medical cases like lung cancer, heart disease, pleural effusions, and arrhythmias. Those with passion and drive for this specialty can make an immediate impact in improving the lives of their patients.
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