WhatsAppSurgical Treatment of Lung, Mediastinal and Chest Wall Disease
The Thoracic Surgery Department provides surgical diagnosis and treatment for diseases of the lungs, pleura, mediastinum (the central compartment of the chest), oesophagus and chest wall. Using modern minimally invasive techniques, above all video-assisted thoracoscopic surgery (VATS), both oncological and emergency cases are assessed by a specialist team.
Contents
What Is Thoracic Surgery?
The Thoracic Surgery Department is the specialty covering surgical procedures on the organs within the chest cavity: the lungs, pleura, oesophagus, trachea, mediastinal structures, thymus gland and chest wall. In addition to oncological pathologies caused by cancer, diseases arising from infection, trauma and structural disorders also fall within the scope of this department. Today, open thoracotomy has largely been replaced by VATS (video-assisted thoracoscopic surgery), a method that means less pain, a shorter hospital stay and faster recovery. In recent years RATS (robotic-assisted thoracic surgery) has come into increasingly widespread use.
Which Diseases and Conditions Are Treated Surgically?
- Lung cancer (non-small cell and small cell lung cancer)
- Mesothelioma (malignant tumour of the pleura)
- Thymoma and tumours of the thymus gland
- Mediastinal masses (lymphoma, teratoma, neurogenic tumours)
- Spontaneous and traumatic pneumothorax (collapsed lung)
- Empyema (collection of infected fluid in the pleural cavity)
- Pleural effusion (fluid collecting in the pleural cavity): for diagnostic or therapeutic purposes
- Bronchiectasis and recurrent antibiotic-resistant lung infections
- Tracheal (windpipe) stenosis and tumours
- Oesophageal cancer and oesophageal diverticulum
- Chest wall tumours and repair after trauma
- Lung metastases (selected cases suitable for surgery)
- Lung nodules (undiagnosed masses)
When Should You Consult Us?
- A mass, nodule or lesion detected on a chest X-ray or computed tomography scan
- A persistent cough, particularly with blood-stained sputum (haemoptysis)
- Chest pain accompanied by unexplained weight loss and night sweats
- Sudden shortness of breath and pain in the side of the chest: this requires emergency assessment for suspected pneumothorax
- Recurrent lung infections or infections that do not respond to antibiotics
- Difficulty swallowing (dysphagia) and pain on swallowing (oesophageal pathology)
- A growing mass in the neck or the front of the chest (suspected mediastinal tumour)
- Investigation of the cause of pleural fluid detected on imaging
Preoperative Assessment
Assessment before thoracic surgery is vitally important for measuring lung capacity and surgical risk accurately. The preoperative assessment carried out in the department covers the following steps:
| Method | What it is used for |
|---|---|
| The primary imaging method for lung nodules, masses, pleural fluid and other pathologies; it forms the basis of surgical planning. | |
| Reveals tumour activity and distant metastasis in lung cancer and other cancer types; it plays a critical role in staging and guides the decision on operability. | |
| Used to examine the airways with a camera, to take biopsies and to assess endobronchial lesions. | |
| A surgical diagnostic procedure used to sample the mediastinal lymph nodes; it is the gold standard for determining tumour spread to the lymph nodes. | |
| Mandatory in planning lung resection in order to estimate functional reserve before and after surgery. FEV1 and DLCO values determine operability. | |
| Cardiac risk classification is carried out with ECG, echocardiography and, where needed, cardiac stress testing, angiography and similar investigations. | |
| Carried out to assess the patient's surgical risk and the form the operation will take. |
Operations and Surgical Procedures Performed
The main surgical procedures performed in the Thoracic Surgery Department are as follows:
| Procedure | Description |
|---|---|
| Covers all thoracoscopic procedures performed under camera guidance without a large incision in the chest wall; it is carried out through one or a few incisions. | |
| Sampling of the mediastinal lymph nodes through the neck; used in staging lung cancer and in the diagnosis of mediastinal masses. | |
| Surgical removal of the oesophagus in oesophageal cancer and reconstruction with gastric or colonic interposition. A transhiatal or transthoracic approach is used. | |
| Surgical removal of the thymus gland in myasthenia gravis or thymoma; performed with VATS or median sternotomy. | |
| Covers operations performed through a few incisions with robotic assistance. | |
| Incisions are smaller than they used to be, but some cases are still performed by opening the chest cavity. |
The Postoperative Process
The period after thoracic surgery requires particularly careful management in order to preserve pulmonary function and prevent complications.
| Topic | What to expect |
|---|---|
| The chest tube is usually removed on the second to fourth day after surgery. | |
| From the first day after surgery, deep breathing exercises, coughing techniques and incentive spirometry reduce the risk of atelectasis and support lung expansion. | |
| Effective analgesia is provided with an epidural catheter or a paravertebral block; this increases the patient's participation in breathing exercises and shortens the hospital stay. | |
| Short walks begin on the first day after the operation; this speeds cardiovascular recovery and reduces the risk of thromboembolic complications. | |
| A hospital stay of 3-5 days after surgery is expected. | |
| After surgery for cancers within the chest cavity, adjuvant chemotherapy or radiotherapy is planned by decision of the multidisciplinary oncology board; recurrence is monitored with periodic CT and PET-CT. | |
| In active smokers, taking part in a smoking cessation programme before and after surgery markedly reduces pulmonary complications; this support is offered within the department. |
You can request an assessment appointment with the Thoracic Surgery Department or call the hospital.
Book an AppointmentThoracic Surgery at Academic Hospital
The Academic Hospital Thoracic Surgery Department manages oncological and emergency thoracic cases under one roof; minimally invasive methods such as VATS and RATS are preferred wherever they are suitable. The decision to operate is taken after joint assessment with the following departments:
- General Surgery: joint assessment in cases that overlap with abdominal and soft tissue surgery
- Pulmonology: pulmonary function tests, bronchoscopy and preoperative clinical assessment
- Medical Oncology: adjuvant treatment decisions and oncological follow-up in lung and oesophageal cancer
- Radiology: chest computed tomography and staging imaging
- Medical Pathology: examination of biopsy and surgical materials, intraoperative consultation
- Anesthesia and Reanimation: preoperative risk classification and planning of one-lung ventilation
- Smoking Addiction Treatment: smoking cessation support before and after surgery
Frequently Asked Questions
References
The general information given on this page about thoracic surgical disease, operative methods and the recovery process is supported by the reliable health sources listed below.
- NHS, "Lung Cancer: Treatment", nhs.uk
- European Association for Cardio-Thoracic Surgery, "Clinical Guidelines", eacts.org
- Mayo Clinic, "Lung Cancer: Diagnosis and Treatment", mayoclinic.org
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
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