Thoracic Oncosurgery

Thoracic Surgical Oncology involves treatment of Tumors involving the chest wall, the lungs and the mediastinum - the space between the breast bone and the spine in the middle which contains the heart, the windpipe or trachea, the food pipe or oesophagus, lymph nodes, the thymus and neurogenic or germ cell tumors.

The lungs are soft spongy organs for exchange of oxygen and carbon dioxide while breathing.

The commonest cause for lung cancer is tobacco in the form of smoking, or exposure to fumes in chemical industries / pollution wherein the lungs harden to a firm solid consistency.

This can be detected as a SPN- solitary pulmonary nodule on a simple chest X-ray. Due to the high prevalence of tuberculosis in India there is a tendency to misdiagnose this as Tuberculosis and empirical treatment of the same tends to delay an early diagnosis of lung cancer.

Other common presenting symptoms of lung cancer include an unrelenting cough often with blood tinged sputum, breathlessness on exertion, unexplained weight loss or bony pains.

Diagnosing these tumors at an early stage allows for better outcomes with surgery.

Surgery for thoracic and mediastinal tumors are now commonly performed using Minimal Access Surgery - also known as VATS - Video Assisted Thoracoscopic Surgery wherein the entire surgery is performed using fine long instruments inserted through a couple of small half to 1 cm sized surgical cuts on the chest wall using a high magnification camera inserted through one of the cuts. This avoids cutting open the firm bony thoracic cage to gain access for surgery. The post operative recovery is thus quick and there is a faster resumption of daily activities.

Similarly low grade carcinoid tumors that involve the windpipe or trachea which takes the air into the lungs can be dealt with in a less invasive manner via bronchoscopy using lasers for resection avoiding very major tracheal surgery.