Besides the surgeries that are performed on the lungs, there are also different types of surgeries that are done on the thoracic area. These include Lobectomies, Esophagectomy, and Tracheal resections.
Video-assisted Thoracic Surgery
During the 1990s, video-assisted thoracic surgery (VATS) for lung cancer was developed. It is a minimally invasive approach that allows for visualization of the lung parenchyma without gas insufflation. However, the definition of VATS has been under scrutiny.
Surgical treatment of lung cancer is best suited for patients with localized early tumors that do not spread. It can also be helpful for the elderly. The use of VATS for anatomic pulmonary lobectomies has been reported to reduce acute postoperative pain and hospital stay.
The technique is safe and has become more widely used in tertiary referral centers. The incidence of perioperative complications in the group undergoing VATS for anatomic pulmonary lobectomies is less than in the thoracotomy group.
The main advantage of this approach for anatomic lung resection is the reduction in hospitalization time and cost. A standardized anesthesia induction and maintenance regimen is used for all patients.
Lobectomies
Depending on the type of cancer, a lobectomy, segmentectomy, or wedge resection may be performed. These surgical procedures can help treat lung cancer.
During surgery, thoracic surgeons like Armen Parajian will remove the tumor from your lung and nearby lymph nodes. This can help prevent the spread of cancer. They will also test for viruses and bacteria in the lymph nodes.
The operation is done under general anesthesia. Your provider will talk to you about how much pain you can expect, how to control it, and what to expect in the days after the procedure. A breathing machine will be hooked up to your throat to allow you to breathe.
Your anesthesiologist will discuss how to prevent pain and discomfort while under anesthesia. You will need to stop eating the night before your surgery.
In most cases, you will stay in the hospital for three to five days. Some patients go home the day after their surgery. The length of your stay will depend on the type of lobectomy you have and your general health.
Tracheal Resection
The surgeon should carefully evaluate the patient’s airway and tracheal connections during tracheal surgery for cancer. Preoperative planning includes detailed bronchoscopy, radiographic imaging of the airway, detailed physical examination, and a thorough history. The surgical approach should be individualized according to the location and size of the lesions.
During a resection, the surgeon removes a segment of the central airway. Tracheal resection and reconstruction are indicated in patients with a tracheal obstruction. Typically, these surgeries are performed under general anesthesia. The complication rate is higher in tracheal resections. However, long-term outcomes are good.
A team of otolaryngologists and pulmonologists should perform the procedure. A preoperative tracheostomy is often required. An experienced surgeon is needed for tracheal resections. The patient should be placed in a supine position in the operating room.
Incisions are made in the cervical collar on the upper third of the trachea. Lateral dissection is limited to a few centimeters to avoid the devascularization of the airway. Depending on the tumor location, performing a full median sternotomy may be necessary.
Esophagectomy
A surgical esophagectomy is a surgery that removes a part or all of the esophagus. This procedure can be performed through either an open or minimally invasive procedure. The type of operation a person undergoes depends on the cancer stage, the tumor’s location, and the surgeon’s preferences.
Usually, a patient will have an incision in the chest, neck, or abdomen. The length of time the surgery takes depends on the type of incision. Anesthesia is usually used.
A breathing tube may be placed in the throat. This will be removed as the patient wakes up from anesthesia. The patient may also have an echocardiogram or an electrocardiogram. The doctor may remove nearby lymph nodes if cancer has spread.
The patient will be moved to the recovery area. The care team will check the patient’s weight and eating habits. They may refer the patient to a dietitian. The patient will also be given dietary guidelines for postoperative healing.
In the case of an esophagectomy, the patient may lose or gain weight. They will have to eat smaller portions. They may have to take antibiotics or nutritional supplements.
