Thoraxklinik-Heidelberg gGmbH

The Heidelberg Thoracic Clinic is one of the largest clinics in Europe specializing in the treatment of lung conditions and is a part of the Heidelberg University Hospital. Today, this certified institution looks back on over 100 years of tradition and has the combined expertise of highly qualified specialist physicians at its disposal. Each year, over 2000 surgical procedures are performed here on the thorax (chest) and the respiratory organs. The hospital has 310 beds and treats 10,500 in-patient cases and 30,100 out-patient cases per year. The Heidelberg Thoracic Clinic has been certified by the German Cancer Association as a Lung Cancer Center since 2009. Thanks to its close collaboration with the German Cancer Research Center (DKFZ), as a partner of the German Center for Pulmonary Research (DZL), and as a founding member of the Heidelberg National Center for Tumor Conditions (NCT), the Thoracic Clinic is actively involved in scientific studies and research. Thus, its express goal as a certified Lung Cancer Center is also that scientific research results are able to be realized in clinical treatment. Consequently, the most up-to-date therapeutic concepts and diagnostic techniques benefiting the patient are employed under one roof at the Thoracic Clinic.

Univ.-Prof. Dr. med. Felix Herth

Medical Conditions

Benign pulmonary conditions

• Bronchial asthma
• COPD, including lung volume reduction
• Interstitial lung conditions
• Sarcoidosis
• Pulmonary involvement in extrapulmonary conditions such as autoimmune conditions, immune deficiencies, etc.
• Rare lung conditions
• Complex infections, pneumonias and tuberculosis
• Diagnosis and treatment of non-tubercular mycobacterioses
• Bronchiectasis conditions including mucoviscidosis
• Infections in HIV / AIDS patients
• Pulmonary hypertension

Malignant pulmonary conditions

• Diagnosis and staging of patients with lung cancer and other bronchopulmonary tumors
• Preoperative function diagnostics
• Diagnosis and staging of primary pleural mesothelioma and secondary pleural tumors
• Diagnosis and staging of pulmonary metastasized, extrathoracic tumors

Special clinic / center services

• Accredited by the European Reference Network for interstitial pulmonary conditions (ERN-LUNG)
• Interdisciplinary diagnosis of complex pulmonary conditions
• Right heart catheter

Endoscopy

• Rigid / flexible bronchoscopy
• Pediatric bronchoscopy
• Endosonography (endonbronchial / endoesophageal)
• Navigated bronchoscopy
• Interventional bronchology therapy (laser, electrocoagulation, stent implantation, brachytherapy with intrabronchial irradiation)
• Endoscopic lung volume reduction
• Endoscopic asthma therapy, internistic thoracoscopy (pleural inspection) for the clarification and treatment of pleural effusion

Respiratory medicine

• Treatment of patients with home mechanical ventilation for chronic respiratory insufficiency
• Non-invasive mask ventilation for acute and chronic respiratory muscle weakness
• “Weaning” (ventilator weaning) for patients with long-term ventilation

Sleep medicine

• Accredited by the German Sleep Research and Sleep Medicine Association
• Diagnosis and treatment of sleep-related respiratory disorders

Cardiopulmonary function laboratory

• Body plethysmography
• Spirometry
• Diffusion capacity
• Blood gas analysis
• Specific and nonspecific provocation tests
• Allergy diagnosis
• Rhinomanometry
• Compliance measurement
• Respiratory effort measurement
• CO2 rebreathing
• Long-term EKG at rest and under load
• Long-term blood pressure measurement
• Spiroergometry
• Echocardiography
• Stress echocardiography
• Transesophageal echocardiography
• Doppler thoracic vascular ultrasound
• Ultrasound-guided lung and pleural puncture
• Pericardial drainage
• Right heart catheter

Univ.-Prof. Dr. med. Michael Thomas

Medical Conditions

• All medical conditions and cancer conditions of the chest region (thorax)
• Non-small-cell carcinoma of the lungs
• Small-cell carcinoma of the lungs
• Pancoast tumor
• Thymic carcinoma
• Pleural mesothelioma
• Pulmonary sarcomata
• Pulmonary metastases of all malignant conditions

Services:

• Daily interdisciplinary case conferences
• Multimodal concepts with surgery and chemotherapy
• Multimodal concepts with radiotherapy and chemotherapy
• Multimodal concepts with radiotherapy and immunotherapy
• Combined treatment approaches with chemotherapy and immunotherapy
• Systemic treatment with molecularbiological stratified therapy
• Systemic treatment with chemotherapy
• Systemic treatment with immunotherapy
• Systemic treatment with stereotactic radiotherapy
• Systemic treatment with IMRT (intensity modulated radiotherapy)

Prof. Dr. med. Claus Peter Heußel

The Department of Diagnostic and Interventional Radiology with Nuclear Medicine provides a wide spectrum of diagnostic and interventional techniques, the most up-to-date imaging techniques and numerous apparatuses. These include:

• Multilayer computed tomography (CT, MS-CT)
• Magnetic resonance imaging (MR, MRI, NMR, magnetic resonance imaging)
• Interventional radiology (biopsy, tumor ablation)
• Projection radiography (conventional x-ray) and fluoroscopy
• Sonography (ultrasound, Doppler / Duplex)
• Nuclear medicine (scintigraphy)

Computed Tomography

• Dynamic CT of the airways for collapse diagnostics
• High-definition CT for diagnosis of lung tissue conditions
• CT-guided biopsy and tumor ablation
• Vascular imaging (angio-CT) of the head, neck and thorax and abdominal region
• Multiphase CT for tumor diagnostics
• Bone density measurement
• Preoperative and preinterventional diagnostics in the course of navigation, in collaboration with the Department of Interventional Pneumonology and Thoracic Surgery

Magnetic Resonance Imaging

• MRI of the lungs (particularly for radiation-sensitive young patients and expectant mothers or for frequently repeated examinations)
• MRI of the pulmonary circulation (perfusion)
• Contrast medium-free imaging of pulmonary embolisms
• MRI of the airways (trachea, airways collapse) during free respiration
• MRI of the diaphragmatic movement during free respiration
• MRI of the heart and flow measurement, e.g. for pulmonary shunts, arteriovenous malformation (AVM), displaced pulmonary vein outlet, pulmonary hypertension
• MRI of the breastbone (sternum)
• MRI of the paranasal sinuses
• Whole-body MRI (orienting examination)
• MR angiography (vascular imaging: arteries and veins of the head and neck, chest and abdominal cavity, pelvis and legs)
• MR cholangiopancreatography (MRCP, imaging of the biliary tract and pancreatic ducts)
• Diffusion MRI (acute cerebrovascular accident and tumor diagnostics) Biopsy and interventional color Duplex sonography
• Areas of application are conditions of the abdominal, the thoracic wall, of the soft tissues, the neck, the lymph nodes and include the thyroid gland

Nuclear Medicine

• Skeletal scintigraphy

Univ.-Prof. Dr. med. Hauke Winter

Medical Conditions

• Pulmonary carcinoma
• Pulmonary metastases
• Pleural effusion
• Emphysema
• Pleural mesothelioma
• Thoracic wall deformities (sunken chest, pigeon chest)
• Tracheal conditions
• Thymic carcinoma / myasthenia
• Also childhood sarcomata
• Tumors of the chest wall
• Mediastinal tumors
• Pancoast tumors
• Pleural mesothelioma

Services:

• Video-assisted minimal invasive techniques (“keyhole surgery”) – uniportal / multiportal
• Standard open procedures (“thoracotomy”)
• Complex multivisceral resection and reconstructive procedures to the chest wall
• Radiofrequency ablation (RFA) -> Prof. Heussel
• Laser surgery
• Plastic surgery to the chest wall
• Plastic closure surgery to the chest wall
• DaVinci surgical robot system
• Lung volume reduction
• Pulmonary empyema surgery
• Tracheal resection
• Port implantation
• Surgery under ECMO
• Diaphragmatic plication
• HITHOC – Hyperthermic intrathoracic chemotherapy perfusion
• Pleurectomy, P3D procedure
• Mediastinoscopy

Where required, surgical procedures are performed jointly with related surgical departments of the University of Heidelberg (Plastic Surgery, Orthopedics, Neurosurgery, Cardiac Surgery, Intestinal Surgery).

Asst. Lect. Dr. Werner Schmidt

Anesthesiology:

• Perioperative care of patients before, during and after diagnostic and surgical procedures
• Application of state-of-the-art and innovative anesthetic and monitoring techniques

Intensive care medicine:

• Care of patients following major surgical procedures
• Monitoring and treatment of all critically ill patients in the hospital
• Care of weaning patients during withdrawal of long-term ventilation
• Focus: Treatment of critically ill patients with acute / chronic lung failure (ARDS / COPD / ILD patients, etc.)
• Application of lung substitution techniques (ECMO)

Emergency medicine:

• Care of all hospital emergencies

Pain therapy:

• Postoperative Acute Pain Service
• Application of advanced systemic and regional pain therapy techniques
• Pain therapy consultation for patients with pain problems

The objective of a Lung Cancer Center is to facilitate the optimal, comprehensive diagnostics, treatment and aftercare of lung cancer for patients suffering from bronchial carcinoma by observing binding quality standards. The most up-to-date diagnostic and treatment techniques, in line with the latest scientific insights, are available for each patient. Each year, over 800 patients with newly diagnosed lung cancer are treated in the Thoracic Clinic. Our objective is to implement the insights of fundamental research into clinically applicable investigations (“translational research”). Individual patient profiles emerge from the entirety of the diagnostic information ascertained. Together with established clinical parameters, these form the basis for treatment, in line with the current guidelines and, at the same time, optimally tailored to the individual patient. A certified Lung Cancer Center also incorporates close cooperation with the hospital’s Department of Psycho-oncology, pastoral care and the Social Service. Interdisciplinary and well-organized networking of this type of the Departments of Pneumonology, Thoracic Surgery, Oncology, Radiology, Radiotherapy and Anesthesiology with the Nursing Service, the treatment departments and the Psychosocial Service “under one roof” provides swift and comprehensive care with the objective of a long-term improvement of the chances of recovery and the survival quality for lung cancer patients. One essential requirement and a core element for certification is treatment within an interdisciplinary concept, involving all of the main treatment partners consisting of pneumonologists, thoracic surgeons, oncologists, radiotherapists, pathologists, radiologists and anesthetists. In our Clinic, this interdisciplinary character has been viewed as the standard for our therapeutic decision-making and already put into practice for many years. All the Chief Physicians, or their Deputies, take part in the major weekly tumor conference. In addition, a daily, joint indication conference has been established in our Clinic for some years. For patients who present at our Clinic for the first time, the further diagnostic investigation is determined in the interdisciplinary concept by Chief Physicians / Chief Residents of the departments referred to.