Common Conditions Thoracic Surgeons Treat
Lung cancer: The most serious cancer in the United States. Surgery is the mainstay for treatment of early and intermediate stages.
Esophageal Cancer: A rapidly increasing cancer that often requires combination multimodality treatment.
Thymoma & other thymic tumors: A tumor that is commonly removed by open surgery but can be successfully resected using the robotic technique.
Achalasia: A rare condition causing difficulty to swallow. Treatment includes the POEM procedure and robotic surgery.
Mesothelioma: A rare cancer usually associated with asbestos exposure. In early stages it can be treated with surgery.
Thoracic Outlet Syndrome
The thoracic outlet refers to the ring formed by the top ribs below the collarbone. It’s a thin passageway that contains many nerves, blood vessels, and muscles. Thoracic outlet syndrome (TOS) occurs when these elements are compressed by the collarbone, neck muscles, or rib at the top of the outlet.
People suffering from TOS may experience:
- Pain in the neck, shoulder, or arm
- Numbness or impaired circulation to affected area
- Lack of color or a bluish color in one’s hand
- Tingling or numbness in the fingers
TOS affects men and women of all ages and can be caused by sports that involve arm or shoulder use, injuries from heavy lifting, sleep disorders, or poor posture.
Tracheobroncomalacia (TBM) is a condition occurring when the bronchial tubes become weak or abnormally collapsible.
Surgical treatment for tracheobroncomalacia involves repairing the back wall of the airway with a procedure called tracheoplasty that can involve robotic surgery.
There are two forms of TBM: primary, the congenital form, which develops during infancy or childhood; and secondary TBM, an acquired form that begins during adulthood.
Common symptoms of TBM include:
- A severe, persistent cough
- Shortness of breath
- Mucus and phlegm becoming stuck in the throat
Refers to excessive sweating that is not related to heat, exercise, or stressful situations. The condition is commonly experienced in the in the underarms, hands, feet, or face, but can affect the whole body.
The symptoms of hyperhidrosis vary widely in severity. Excessive sweating can lead to:
- Body odor
- Excessive itching or inflammation
- Marks on clothing
- Skin changes like cracks, wrinkles, or discoloration
If the use of prescription-strength antiperspirants or other medications don’t alleviate excessive sweating in the armpits, removing the sweat glands there can be an effective treatment option. Another option is suction curettage, a minimally invasive surgical technique in which a suction tool is inserted into two small incisions to suction out the sweat glands.
Myasthenia gravis is a neuromuscular disorder in which the immune system produces antibodies that block or destroy receptor sites on the muscles for the neurotransmitter acetylcholine. This impairs the communication between nerves cells and muscles, leading to muscle fatigue and weakness.
Other symptoms of myasthenia gravis can include:
- Double vision
- Trouble with speech, swallowing, or breathing
- Drooping eyelids
Symptoms can improve with rest but be worsened by factors like illnesses, surgery, stress, menstruation, and some medications like beta blockers and antibiotics.
Researchers believe that that thymus gland, located in the chest below the breastbone, is responsible for the antibodies that block acetylcholine.
Complex Hiatal Hernia
A hiatal hernia occurs when the upper section of the stomach bulges up into the chest through the hiatus, a small opening in the diaphragm. A complex paraesophageal hiatal hernia is when the whole stomach, spleen, pancreas, small and large bowels, or liver is pushed up into the chest.
Hiatal hernias may be caused by:
- Being born with a large hiatus
- Changes to the diaphragm related to age
- Injuries related to trauma or certain types of surgery
- Persistent pressure on the surrounding muscles from vomiting, coughing, or heavy lifting
A common treatment option is fundoplication, a surgery in which the upper part of the stomach is wrapped around the esophageal sphincter in order to strengthen it.
Endoscopic fundoplication for GERD
In addition to treating a hiatal hernia, fundoplication surgery is also used to treat gastroesophageal reflux disease (GERD), a digestive disorder where contents of the stomach flow back into esophagus, causing irritation. Also called chronic acid reflux, GERD occurs when the lower esophageal sphincter doesn’t close properly, causing acid backwash to flow back into the throat and mouth.
The primary symptoms are acid regurgitation and heartburn, but GERD sufferers may also experience hoarseness of the voice, chest pain, or trouble swallowing.
Achalasia is a rare disorder in which damaged nerves prevent the esophagus from properly moving food and liquids down into the stomach. When the lower esophageal sphincter (LES), a ring of muscle where the esophagus meets the stomach, can’t relax, food can back up into the esophagus.
Peroral endoscopic myotomy (POEM) is a minimally invasive procedure to treat achalasia in which muscles on the side of the esophagus, the LES, and the upper part of the stomach are cut. These incisions loosen the muscles and allow the esophagus to empty like it normally should, passing food down into the stomach.
Our thoracic surgery team is also part of the Thoracic Multidisciplinary Clinic at the Lifespan Cancer Institute, where our experts use the most advanced thoracic surgical options to treat lung cancer, as well as conditions like carcinoid tumors and mesothelioma.