Thoracic Disorders and Diseases - Thoracic Surgery
Thoracic Disorders and Diseases
Minimally invasive surgical techniques are used preferentially in all facets of the GBMC thoracic surgery practice. Patients undergoing Video-Assisted Thoracoscopic Surgery (VATS) for diagnostic and/or therapeutic procedures in the chest or laparoscopic procedures for treatment of swallowing problems, generally experience fewer complications, less pain and scarring after surgery and consequently have a quicker recovery.
Procedures include lung biopsy, lymph node biopsy for diagnosis or staging, lung wedge resection, lobectomy, pneumonectomy, drainage of pleural or pericardial effusions, decortication, sympathectomy, first rib resection, thymectomy, esophagomyotomy, fundoplication, diverticulectomy or hiatal hernia repair.
The Division of Thoracic Surgery at GBMC offers expertise in the treatment of the following diseases:
Most patients seen at GBMC Thoracic Surgery have been diagnosed with lung cancer. Many of the surgeries for lung cancer are done minimally invasive, also referred to as VATS (video-assisted thoracic surgery), and involve removing portions of lung as part of treatment for your lung cancer.
As part of the Sandra & Malcolm Berman Cancer Institute, thoracic surgery is involved in a multidisciplinary thoracic tumor board, which includes medical oncology, radiation oncology, pulmonary, radiology, pathology, nurse advocates, nutrition, and clinical research. This group meets regularly to discuss our patients with lung cancer in order to develop individualized treatment plans and make sure we are providing excellent standard of care.
A pulmonary nodule is an abnormal growth of tissue in your lung. Most people with lung nodules do not have any symptoms. Most of the time, they are found incidentally when a chest X-ray is done for another reason. Nodules can be caused by:
- Infection
- Inflammation
- Benign tumor
- Malignant tumor
A pulmonary nodule is almost like a mole on your skin. Most moles are not cancer, but you get them checked out to make sure they are not changing and concerning for cancer. The same applies to lung nodules. A thoracic surgeon helps evaluate, monitor, and perform surgery to remove the nodule for diagnosis and/or treatment as appropriate.
Hiatal hernia (or paraesophageal hernia) is when your stomach has slid up into your chest. This may cause bad reflux, excessive belching, feeling of food getting stuck or chest pain after eating. It is recommended to fix the hernia if you are having symptoms. At GBMC, this is a laparoscopic surgery to move your stomach back in to your belly and tighten your diaphragm muscle to prevent it from sliding back up.
A pneumothorax, also known as a collapsed lung, is when air gets into the space outside your lung and pushes it to collapse. Most commonly this occurs after a trauma (rib fracture) but in some patients can happen spontaneously causing shortness of breath or pain to one side of your chest with breathing. Some may resolve on their own or need placement of a drain to release the air. In patients with repeated spontaneous episodes, surgery is done to prevent these from happening again.
Pleural effusion is fluid that accumulates outside your lung causing shortness of breath by not letting the lung fill with air. This can be related to several medical conditions, including cancer. If this is a persistent problem, your physician will refer you to thoracic surgery to either help diagnose why this keeps happening and/or perform a procedure to prevent it from accumulating again.
Empyema is when there is in pleural effusion that is infected around your lung. A thoracic surgeon can perform a surgery to clean out this infection and help your lung be able to fill back up with air.
Some people develop issues with the tissue of their lungs causing them to be short of breath. This can be from infection, inflammation, or an underlying immune disease. Your pulmonologist may refer you to a thoracic surgeon to have a biopsy to get tissue to help diagnose what is happening to your lung so you can get the appropriate medication to treat it.
Masses, both cancer and noncancer, can develop on our rib cage causing pain and chest deformity. Surgery is done to remove the portion of your chest that is affected and reconstruct it.
Most fractures of the sternum or rib will not require surgical intervention. They can be very painful and take several months to recover from. The main goal in recovery is to prevent pneumonia from developing because these fractures make it harder to do our normal day to day breathing.
Hyperhidrosis is excessive sweating that's not always related to heat or exercise. You may sweat so much that it soaks through your clothes or drips off your hands. Heavy sweating can disrupt your day and cause social anxiety and embarrassment.
Treatment begins with special antiperspirants. If these don't help, you may need to try different medications and therapies. In severe cases, your health care provider may refer you to thoracic surgery to disconnect the nerves related to producing too much sweat (Sympathectomy).
Achalasia is nerve disorder that makes your esophagus unable to squeeze food down into your stomach appropriately. This can lead to regurgitation of your food or chest pain. A gastroenterologist has evaluated you, and perhaps attempted treatment, for this diagnosis before you see a thoracic surgeon.
Surgery, done laparoscopic, involves cutting a muscle at the end of your esophagus to allow food to empty into your stomach easier.