Fad or the future? In my last blog I touted the benefits of minimally invasive chest surgery, thoracoscopy, which provides as good outcomes as open surgery but causes much less pain and allows patients to recover quicker. So-called robotic surgery is felt by some surgeons to be the next advance Read More
Category: Thoracic Surgery
Less is more…beneficial. For years surgeons had only one option for an operation to provide access to internal organs: open surgery performed through a usually generous incision through skin and muscle. In a chest operation the access procedure to get inside a chest is called a thoracotomy. It begins with Read More
Making life better. Not all cancers are curable. When this is the case subjecting the patient to a major operation such as an esophagectomy with its risks of significant morbidity and even mortality is inappropriate. Happily, there are interventions that can improve the quality of life and extend it. Both Read More
Sweat. Can’t live with it, can’t live without it. Don’t sweat it. Bad advice if taken literally. Sweat plays an important role in preventing hyperthermia, when the body overheats. Hyperthermia can be fatal as internal organs over heat and eventually fail. The beads of salty water we call sweat evaporate Read More
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
