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Thoracic Surgery

Thoracic surgery is the field of medicine involved in invasive diagnostics and surgical treatment of diseases and pathological conditions of the organs inside the chest (thorax). Which means that the areas of interest of thoracic surgery include the contents of the chest, viz., primarily, the lungs, trachea, bronchi, esophagus, pleura (membrane lining the chest cavity from the inside), diaphragm (muscular partition separating the thoracic and abdominal cavities), thymus gland, pericardium, heart (which cardiosurgeons are responsible for), intrathoracic large vessels, nerves, lymph nodes, lymph flow, thoracic wall with the sternum, ribs, muscles, and connective tissue.

Such allocation of thoracic surgery is rather vague, since everything is very closely interconnected in the organism.

A thoracic surgeon often deals with the complex issues of the whole body. For example, pathological accumulation of fluid in the chest cavity (pleural effusion), inconsistent with breathing and proper heart work, may result from many factors, be a complication of some other diseases. For example, tumors of female genitals can often be caused by the development of pleurisy, about which a female patient seeks medical assistance, being unaware of such relationship.  

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As a rule, patients directly seek treatment by a thoracic surgeon only on rare occasions, when the patient has already had a similar problem, which involved a thoracic surgeon, for example, pleurisy, spontaneous pneumothorax (occurs when there is a sudden rupture of the lung against the background of full wellbeing).

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Most often patients come to the thoracic surgeon, referred by other medical professionals, when there is a suspicion for the presence of disease or injuries of the chest, or there is a need for those methods of diagnosis and treatment, which only thoracic surgeon can do. They can be general physicians, pulmonologists, cardiologists, neurologists, radiologists, surgeons of other specialties, gynecologists, gastroenterologists, endocrinologists, hematologists, and oncologists.

What symptoms are most common for diseases of the chest? Chest pain, coughing, especially long time coughing, which produces sputum, coughing with blood, shortness of breath (feeling of lack of air), accompanied by quickening of breath. Sometimes the presence of neoplasms in the thorax, which patients can touch themselves. There is a long malfunction of swallowing. Other symptoms are more specific in each situation and should be identified by a specialist. In the case of some diseases, symptoms and clinical manifestations occur only in advanced stages, for example, lung cancer, which is entirely asymptomatic in early stages.

The most effective and correct way to protect yourself from such diseases are annual preventive check-ups, chest x-ray, which can identify the problem at an early stage, before the manifestation of clinical symptoms (cough, shortness of breath, pain, etc.). Therefore these procedures should not be neglected, they are important not for physicians, but for the population in particular.

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Combating the scourge of our time—smoking—is of great importance.  The relationship of this addiction with the emergence and development of lung cancer is clearly proved today. Unfortunately, despite all the measures taken by the government to combat tobacco use, the number of people who are addicted to tobacco, does not reduce. It is generally known fact that, besides harming their own body, smokers put people around at high risk.

The aggressive environment of modern cities with its smoke, dust content, and gas contamination also carries nothing good for our lungs. The microparticles of dust and smoke, by settling in the lungs of the urban dwellers, create favorable conditions for the development of lung cancer. Today, lung cancer ranks first among the most common cancer types and causes of death in highly developed countries. In some regions, it reaches numbers over 100 cases per 100,000 population.

One more major problem of today, which is closely linked to environmental factors, are so-called Chronic Obstructive Pulmonary Diseases (COPD). If every third smoker gets sick with lung cancer during the life—alas, such is the inexorable statistics—then 100% of smokers for 10 years of smoking will suffer from COPD of varying degrees of severity.

What is COPD? It is the formation of barriers to the movement of air in the respiratory tract. This gradually leads to deterioration of oxygen supply to body tissues, ineffective breathing, swelling and destruction of lung sections involved in gas exchange. That is, anatomically the lungs turn into multiple bubbles, impossible to breathe with.

Smokers suffer from shortness of breath after even a trivial exercise, such as climbing stairs. Considerable quantities of sputum produce each morning. A more advanced stage—shortness of breath occurs even at rest and during conversation. Skin color changes, spontaneous rupture of lungs is possible, the lungs turn into thin bubbles, incapable of gas exchange. Unfortunately, today, patients opt to seek treatment in a seriously deteriorated health condition, when only transplantation of donor lungs can help them. This procedure is far from complete (only about two dozen such transplantations have been made in Russia, with approximately 5,000 in the world). Being extremely difficult technically, such procedure is limited to the possibility of the selection of the adequate cadaveric donor (!), and, respectively, costs huge amounts of money. Moreover, usually in such stages with long-term respiratory failure, there are changes in other organs and systems, which sometimes make it impossible to have the surgery at all.

Cardiovascular and Thoracic Surgery Center operates within the structure of the FEFU Medical Center. We are involved in diagnosis and treatment of diseases of the chest. Our priority is the provision of high-tech medical care. There are operating rooms in our Center corresponding to all modern requirements and standards, equipped for challenging mini-invasive interventions:

- Endoscopic equipment (tower and instruments)

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- HARMONIC ultrasonic energy device,

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- LigaSure bloodless tissue dissection device,

- Universal suturing devices.

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Many of the surgeries are performed with the use of so-called endosurgical techniques—video-assisted thoracic surgery (VATS). The surgeries are carried out by doctors trained in central clinics and overseas hospitals. Our doctors regularly participate and organize scientific and practical conferences, that allows us to be in the trend and to keep track of modern standards and achievements in medical science and technology, in order to apply them in the treatment of the patients.