Air in the chest. The lungs completely fill the thoracic cavity (the inside of the chest) as we breath in and out. During the normal respiratory cycle the chest enlarges as chest wall muscles draw it out and the diaphragm descends. This creates negative pressure which expands the compliant lungs. Read More
Category: Lung Surgery
It has been said that the only excuse for smoking…is being on fire. I want to discuss and emphasize the carcinogenic (cancer causing) effects of cigarette smoke. Then we can review the role of thoracic surgery and thoracic surgeons in the care of patients with lung cancer, the subject of Read More
Be prepared. The lung cancer in most patients on whom we thoracic surgeons operate is situated entirely within a lobe of the lung and a lobectomy is a sufficient operation. Occasionally, as previously discussed, it is too large or is positioned such that an entire lung must be removed; a Read More
Homogeneity does not describe the surgical community. This can confuse someone looking for the right lung cancer surgeon. There are general surgeons and thoracic surgeons (who have confusingly self-divided themselves into cardiac, cardiothoracic and general thoracic subspecialties). Within all these surgical groups can be found surgeons who operate for lung Read More
Goldilocks…the principle, not the character. The thoracic surgeon must get the operation “just right.” Take out too much lung and the patient is forever short of breath; not enough and the cancer is not cured. As I discussed in a previous blog, Evarts Graham, a surgeon in St. Louis, performed Read More
Staging cancer…it has nothing to do with the theater. In short, staging is determining the extent of the lung cancer. Is the tumor invading into structures outside the lung such as the rib cage or the heart? Has the cancer spread through the lymphatic system to lymph nodes near but Read More
Lung operations in humans arrive. In 1931, Rudolf Nissen reported the first successful pneumonectomy (removal of an entire lung in surgeonese). His patient was a 12-year-old girl with chronic infection. She suffered a cardiac arrest during an initial attempt, was resuscitated and underwent the successful operation two weeks later. Nissen Read More
Things move along. Lung surgery developed, albeit at a moderate pace and all for infection. In the pre-antibiotic era the only therapeutic options were to drain an abscess cavity or to excise an infected area of the lung. In 1885 an Italian surgeon performed perhaps the first successful lobectomy in Read More
Animals and Humans A few years after Péan’s operation Block, a Polish surgeon, advanced the possibility of operating on the lung when he reported the successful performance of pneumonectomy (removing the entire lung) in rabbits. His reports and demonstrations of his technique to curious surgeons created a modest stir in Read More
Trauma Leads the Way Let’s begin with Rolandus’s story from 1499. He needed more than a little persuasion to act! “Called to a citizen of Bologna on the sixth day after his wound, I found a portion of the lung issued between two ribs; the afflux of the spirits and Read More
