Thoracic Surgery--(Surgery For Terminal Lungs Disease)

THORACIC SURGERY

A wide variety of thoracic surgical procedures are performed at the Favaloro Foundation. Surgeries performed by the service include lung surgery, pleural space, trachea, chest wall, mediastinum, and esophagus. These surgeries are performed through the use of modern technology and innovative procedures. Currently procedures are performed by minimally invasive methods (video-assisted surgery by video-assisted thoracoscopy) and by conventional means (thoracotomy).

Currently, up to 70% of surgeries are performed by videothoracoscopy. This type of surgery is a breakthrough in the field of thoracic surgery. It is characterized by access to the thorax with two or three small incisions (usually 1 to 2 cm each) with which the section of the muscular planes is limited. This not only provides a better cosmetic result, but also reduces postoperative pain, recovery time, surgical trauma and, apparently, also the chances of post-surgical respiratory infections, recognized as the most frequent complications of thoracic surgery. In addition, it reduces the time needed to resume daily activities. Currently, procedures such as lung biopsies, pleural biopsies,

In conventional surgery (thoracotomy), slightly larger incisions are made that allow working under direct vision on the organs that are being operated on. They are usually more complex procedures that cannot be performed by minimally invasive methods.

 LUNG CANCER SURGERY

The Favaloro Foundation has a comprehensive team of doctors dedicated to the diagnosis and treatment of lung cancer. Bronchoscopic and percutaneous diagnostic procedures are performed for the diagnosis of lung lesions. Those patients with early lung cancer may benefit from minimally invasive lung resections, assisted by videoendoscopic methods. They are performed with three small incisions in the chest, which minimizes surgical trauma and facilitates postoperative recovery without jeopardizing the oncological principles of lung surgery. In addition, conventional lung resections are performed for larger, more advanced lung lesions and bronchoplastic procedures for central airway lesions.

 PLEURAL SPACE SURGERY

Most of these diagnostic and therapeutic procedures are performed with minimally invasive videothoracoscopic methods, which reduce postoperative recovery time and return to daily activities.

Pleural drains are used for outpatient use in patients with chronic pleural effusions. These are easy to use for the patient and minimize hospitalization times.

 MEDIASTINAL SURGERY

Much of these procedures can be performed through minimally invasive techniques, such as mediastinoscopy, tumor resection, and video-assisted diagnostic procedures.

 SURGERY FOR TERMINAL LUNG DISEASE

Surgical options for these types of patients include lung volume reduction surgery and lung transplantation. The first can be performed videothoracoscopically as well as conventionally, depending on the characteristics of each patient, and consists of removing the most affected portions of the lung to allow a better function of the healthiest regions. Not all patients can undergo this procedure since the prerequisite of this surgery is that there are more affected lung areas in the upper lung portions, which does not occur in all patients. Those patients who are not candidates for lung volume reduction surgery can be evaluated for lung transplantation, whose program at the Favaloro Foundation is the most active in Argentina.

 OTHER PROCEDURES

Among others, we can mention the following surgeries: resections of chest wall tumors that may or may not require complex reconstructions, surgery of the trachea for benign and malignant strictures, and surgery of the diaphragm. Chest wall surgeries may require the collaboration of different surgical teams in addition to thoracic surgery, such as plastic surgeons, cardiovascular surgeons, and neurosurgeons.

 POSTOPERATIVE CARE

In the cases of major surgeries, during the postoperative period the patients remain in the Cardiovascular Recovery Unit. If the procedure is of lesser magnitude the patient goes directly to areas of less complexity. Patient care is carried out by a team of professionals made up of intervening thoracic surgeons, intensivist physicians, clinical physicians, pulmonologists, physical therapists, and nurses. Recovery is focused on early mobilization from the first post-surgical day and encouragement to resume normal daily activities in order to accelerate recovery and avoid complications that may cause a prolonged hospitalization.

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