When it comes to diseases, injuries, or congenital abnormalities in the chest cavity, the thoracic surgeon steps in. The thoracic cavity includes the pleura, the bronchi, the lungs, and the trachea. The mediastinum (the space between the sternum and the thoracic spine) also falls within the scope of thoracic surgery.
Pneumonia, inflammation of the pleura, or collections of pus in the chest cavity are all conditions treated by thoracic surgery. The same applies when air enters the pleural cavity (pneumothorax).
Specialists also treat congenital chest deformities such as pectus excavatum. In cases of tumors in the chest cavity, thoracic specialists work together with oncologists to treat lung cancer and lung metastases.
As in all areas of surgery, this includes treatments that do not require surgery. In thoracic medicine, these include, for example, radiation therapy or chemotherapy for the treatment of lung cancer, or the use of antibiotics.
The chest cavity (thorax for short) contains the vital organs—the heart and lungs. Surgery on the thorax may be necessary as a result of accidents, cancer, or narrowing of the bronchi. These surgeries are performed by thoracic surgeons.
According to the definition of the German Society for Thoracic Surgery, thoracic surgery encompasses the diagnosis and treatment of:
- Diseases, malformations, and injuries of the chest wall
- Diseases, malformations, and injuries of the diaphragm
- Diseases, malformations, and injuries of the lungs and adjacent parts of the heart
, the chest is also called the thorax; it is the upper part of the torso @ Katleho Seisa/peopleimages.com /AdobeStockWhat conditions do thoracic surgery specialists treat surgically?
Thoracic surgeons primarily focus on the surgical treatment of:
- Lung diseases (lung cancer, lung metastases, pulmonary emphysema) as part of lung surgery
- Pleural diseases (peritoneal carcinomatosis)
- Bronchial diseases
- Diseases of the chest wall (funnel chest, chest wall tumors)
- Mediastinal diseases (thymic carcinoma) as well as
- Tracheal diseases (tracheal cancer)
Pectus excavatum is a malformation of the anterior chest wall that is often genetically caused @ smile35 /AdobeStockWhenever possible, thoracic surgery specialists prefer minimally invasive procedures to reduce the risk of infection. At the same time, this also increases the likelihood of a complication-free recovery following thoracic surgery.
Two particularly common conditions in thoracic surgery are pneumothorax and fluid accumulation in the chest cavity.
When air from outside enters the chest cavity, the lung collapses and breathing becomes difficult. Doctors refer to this as a pneumothorax.
In this case, the thoracic surgeon must identify the cause of the pneumothorax and seal the underlying injury.
They remove the air from the chest cavity and repair the chest wall so that no more air can enter.
The situation is very similar when fluid accumulates in the chest cavity, usually as a result of infections or tumors.
In such cases, the thoracic surgeon drains the fluid. This prevents pathogens from settling around the lungs or tumor cells from spreading.
What diagnostic procedures do thoracic surgery specialists use?
However, before thoracic surgery specialists can open the chest cavity, they must first get a clear picture of the inside of their patient’s body. To do this, they use various imaging techniques, such as X-rays, ultrasound, or radiological scans.
To rule out infections, it is recommended to perform a bronchoscopy or even a pleural tap before surgery. Only after all these tests have been completed and the patient appears fit for surgery does the thoracic surgeon proceed.
What does the range of services provided by thoracic surgeons look like?
Thoracic surgeons, as the name suggests, are primarily surgeons. Therefore, their scope of practice includes, in particular, thoracotomy and thoracoscopy. Doctors define thoracotomy as the surgical opening of the chest through an incision between the ribs. Different types of thoracotomy are distinguished based on the location and size of the incision.
Thoracoscopy is a minimally invasive procedure that allows doctors to examine the chest cavity and the pleura. Using this thoracic surgical technique, they can insert instruments or administer medications into the chest cavity.
What qualifications do specialists in thoracic surgery have?
Thoracic surgery is a subspecialty of general surgery. Aspiring specialists in thoracic surgery are generally required to complete a training program. This includes a 2-year basic training in surgical techniques and a 4-year specialization phase in thoracic surgery.
