Thorax is a Latin word derived from the Greek language for the chest. Thoracic surgery, therefore, refers to surgery of the thoracic or chest cavity. Chest cavity is the part of the body between the neck and tummy and you can easily identify it as it is closely guarded by 12 ribs on either side of your chest and rightly so because the chest cavity houses some of the most important yet very delicate inner organs including lungs, the windpipe, the food pipe and the muscle sheet separating the chest from the tummy called the diaphragm. Any damage to these high priority organs including the heart itself can be life-threatening.
However, it is amazing that symptoms requiring a chest surgeon’s help, except in accidents and emergencies, may be so simple that you would fail to recognize you might need a chest surgeon’s help.
So Why would Sweaty Palms Need Surgery?
Obviously, not all people with sweaty palms need surgery. However, a condition called “hyperhidrosis” which is excessive sweating on the palms, the underarms, the face and rarely on the feet too requires a nerve chain in the chest called the sympathetic nerve to be cut. This procedure is called “Sympathectomy”.
Similarly, most chest problems for which you would think a physician is enough, sometimes turn out to be more sinister and require a surgeon’s intervention. Particularly, a cough that does not settle and does not turn out to be positive for tuberculosis or obstructive airway disease in long-term smokers, may need screening for cancer and may need biopsies for detection and removal of part or whole of a lung to eliminate cancer.
Sometimes simple but horrifying symptoms like shortness of breath and wheeze that would not go away, may turn out to be narrowing of the windpipe and may require surgical removal of the narrow part. Same may be needed for the food pipe when there is difficulty in swallowing due to narrowing caused by inflammation or cancer.
Shoulder pain in the arm is sometimes a very bothersome symptom occurring due to an extra rib on the top of the rib cage called a cervical rib. In severe cases, it may need to be removed.
Thus thoracic cavity problem is not caused by the single issue. Many organs reside in this protected area and any damage to any organ will take you to the surgeon.
It is logical that when one notices any of the above-mentioned symptoms one tends not to see a surgeon but goes to a physician or at best a pulmonologist or chest specialist. In most cases, the physician will get blood tests, x-rays or CT Scans done and sometimes will find out something that requires probing into deeper.
Because surgical chest problems may remain hidden for long times, they usually are severe when detected. It is therefore very important that one goes immediately into action if such pathology is detected and the physician is advising surgical opinion. The sequence of surgical interventions starts with a biopsy.
This is basically a diagnostic technique in which the surgeon removes some tissues or cells from the lungs to confirm the presence and level of the disease. The removed tissue is sent to the lab and usually can take anywhere between 3 to 5 days to be reported. Depending on the findings of the biopsy there may be nothing further required except medical treatment. In case a lesion is found in the lungs that need removal and is removable, the choices may be a lobectomy or a pneumonectomy.
Our lungs are naturally divided into smaller sections by some natural cut lines. These sections are called lobes. The right lung has three lobes and the left one two lobes. Lobectomy is a surgical procedure to remove the entire lobe of a lung with a tumor or for some other reason.
This surgical procedure is done to remove the whole lung and is mostly done in cancerous lungs.
Anatomical segmental resection:
This surgical method is not only used to remove the tumor but also the blood vessels, the lymphatic drainage and the lung segment which are affected by the tumor.
Blockage of the windpipe can cause immediate death for lack of ability to breathe. A tracheostomy is an emergency procedure performed to make a hole; a surgical opening, in the windpipe through which air exchange can occur till the problem causing the blockage can be removed or treated.
Myasthenia Gravis is a disease that affects the muscles responsible for movements of arms and legs and the muscles of the chest wall that help us breathe. The weakness in these muscles slowly makes the patient incapacitated, weak and unable to breathe. The initial treatment is with medication but eventually, these patients require a surgery in which a gland in the chest called Thymus has to be removed. The surgical procedure is called a Thymectomy.
Other frequent procedures in the chest include but are not limited to insertion of chest tubes if a lung gets punctured and collapses, surgeries to remove tumors around the food pipe and removal of cervical ribs.
Around the middle of the last century, it was considered miraculous if patients with such sinister problems could be saved. Today, however, with modern developments in chest surgery, patients in initial stages of cancers and other diseases hold a very real chance of long-term survival.
In Lahore, all these modern procedures are under practice at Masood Hospital. Our pulmonologist and thoracic surgeon work as a team to coordinate optimum delivery of medical care to the needs of the chest patients according to standard international guidelines.
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