Thoracic Surgery

Overview of the department

We are responsible for surgical treatment for diseases of the lungs, bronchus, mediastinum, pleura, and thoracic wall. The mean annual number of patients who underwent surgery in the Department of Thoracic Surgery during the past 3 years was 145. Of these, surgery for primary lung cancer was performed in approximately 60. In particular, Video-Assisted Thoracic Surgery (VATS) has recently been promoted. It has been indicated for patients with benign diseases, represented by pneumothorax, and those with early lung cancer, targeting minimally invasive surgery.

Consultation system/therapeutic strategies

In the Department of Thoracic Surgery, VATS is introduced in patients with benign diseases, represented by pneumothorax, and those with early lung cancer, targeting minimally invasive surgery (90% or more of all patients). In addition, VATS is also performed to treat metastatic lung cancer, benign lung tumors, mediastinal tumors, pulmonary emphysema, pleural diseases, and palmar hyperhidrosis. VATS radical limited surgery to preserve the lung function such as segmental resection is indicated for some patients considering an increase in the early detection rate of lung cancer with recent advances in diagnostic imaging procedures (thoracic CT, PET).

Fields of expertise

Video-Assisted Thoracic Surgery (VATS), multidisciplinary treatment for primary lung cancer, and intrathoracic perfusion hyperthermo-chemotherapy (IPHC)

Advanced medical practice

Thoracoscopic surgery

For diagnosis and treatment, thoracoscopic surgery is introduced in all patients. The degree of preoperative pleural adhesion is evaluated using ultrasonography of the thoracic wall, and minimally invasive, highly accurate, thoracoscopic surgery is performed. Lung-volume-reduction surgery for severe pulmonary emphysema, Nuss’s surgery for funnel chest, and sympathetic nerve cauterization for palmar hyperhidrosis are also combined with thoracoscopy. Concerning spontaneous pneumothorax, the Jelly Fish method, which was devised and introduced in our department, has been used during the past 8 years. There has been no recurrence, leading to favorable results.

Preoperative introduction therapy/postoperative adjuvant chemotherapy

In our department, various clinical studies for induction and adjuvant therapy of primary lung cancer are proposed and conducted, with an increasing number of patients. To achieve more potent chemotherapy for advanced lung cancer, preoperative induction therapy (anticancer agents + radiation therapy) and postoperative adjuvant chemotherapy based on the results of anticancer agents sensitivity tests are carried out. As its outcome, the 5-year survival rate was 48% in stage-IIIA and -IIIB patients who underwent surgery; multidisciplinary treatment for advanced cancer was effective, and favorable results were obtained.

Treatment for cancerous pleuritis related to lung cancer

A clinical study, “Intrathoracic paclitaxel infusion therapy for non-small cell lung carcinoma with cancerous pleuritis”, which was developed in our department, has been proposed to a large number of patients. In patients with relatively mild cancerous pleuritis, intrathoracic perfusion hyperthermo-chemotherapy (IPHC, clinical study) is performed. Long-term survival has been achieved in some patients.

Effective utilization of PET

PET plays an important role in lung cancer treatment. Therefore, several clinical studies using PET have been proposed and conducted pre- and post-treatment diagnosis, accurate diagnosis for staging, relapse diagnosis, and evaluation of the treatment response.

Diseases treated in our department

Primary lung cancer, metastatic lung cancer, benign lung tumors, mediastinal tumors, spontaneous pneumothorax, palmar hyperhidrosis, funnel chest, and severe pulmonary emphysema

Primary examinations and explanations

More accurate preoperative diagnosis is performed with the latest equipment, including PET-CT. In our department, prior to surgery, in-depth discussions and simulations with surgical assistants are conducted based on preoperative diagnostic imaging findings. We believe that safety than minimally invasive is more important in surgery. During treatment, we are making efforts to give accurate, understandable information from patients’ and their families’ viewpoints and considerate medical services. It is possible to provide second opinions. After preparing laboratory/examination data and a patient referral document (letter of referral), please call the Department of Comprehensive Medical Care (ext. 3499, 3565), specify Dr. Sasaki, Department of Thoracic Surgery, and make a reservation.