You might think that the esophagus—it starts in the neck but most of it nestles safely within the chest and abdomen, guarded by ribs and a lot of tissue—is safe from being burned. Not so. Just as food has access to the inside of the esophagus so do a variety Read More
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What is the goal of an esophagectomy? The answer may seem obvious, but it was not always so. As recently as when I began my practice in the early 1980s the hoped-for outcome was that the patient’s dysphagia would be relieved. Cure of the cancer was a welcome result but Read More
Into the chest. The chest is the home of most of the esophagus, so it is the location of most cancers. Operating in the chest was impossible until sufficient anesthesia capabilities were established and the lungs could be ventilated. No awake and sentient patient could tolerate the pain of a 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
How to get inside? This was not a meaningful question until the 1990s. Up till then the only route in was by an open thoracotomy. (from thorax, chest, and -otomy, to open) The figure illustrates. A cut in the skin and muscles is parallel to the ribs which are spread 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
