Treatments provided by Marco Scarci

Pectus excavatum (PE), also known as funnel chest is by far the most common chest wall deformity. Pectus carinatum (PC), the next most common chest wall deformity, is less common than pectus excavatum. Treatment for pectus excavatum can involve either invasive or non-invasive techniques or a combination of both. The Ravitch technique is an invasive surgery. It involved creating an incision along the chest through which the cartilage is removed and the sternum detached. A small bar is then inserted underneath the sternum to hold it up in the desired position. The bar is left implanted until the cartilage grows back, typically about 6 months. The bar is subsequently removed in a simple out-patient procedure. Thiis invasive procedure is often used in older patients, where the sternum has calcified, when the deformity is asymmetrical, or when the less invasive Nuss procedure has proven unsuccessful. The Nuss procedure is a technique that is minimally invasive. This procedure involves slipping in one or more concave steel bars into the chest, underneath the sternum. The bar is flipped to a convex position so as to push outward on the sternum, correcting the deformity. The bar usually stays in the body for about two years, although many surgeons are now moving toward leaving them in for longer. When the bones have solidified into place, the bar is removed through outpatient surgery. Both procedures are two-stage procedures.

A lobectomy is most often performed during a surgical procedure called a thoracotomy (surgical incision of the chest). A lobectomy is a surgical procedure performed to remove one of the lobes of the lungs. It may be performed if an abnormality has been detected in a specific part of the lung, such as early lung cancer.

Because mesothelioma is most often diagnosed in its later stages, any type of curative surgery for the disease is rarely an option. A number of surgical procedures have been recommended for mesothelioma patients. Some are quite simple and may be performed more than once, while others are quite drastic and are done as a last resort.

Thoracentesis is probably the most frequent surgical procedure performed. This involves the aspiration of fluid from the area around the lungs. The removal of the fluid can make the patient more comfortable and temporarily relieve symptoms of the disease, such as chest pain or shortness of breath.

Pleurodesis is a procedure tat involves the injection of talc or other chemicals into the chest cavity, which causes scarring and prevents fluid from returning. The American Cancer Society reports that this procedure has about a 90% success rate and that it will eliminate or significantly reduce the build-up of fluid at least temporarily in a majority of patients.

Pleurectomy and decortication is the most complicated surgical procedure. The pleurectomy/decortication involves removal of the pleura - the lining of the lung - where the tumour is located. This procedure is performed with “radical intent”. While it is not possible to cure the disease, this procedure aims to remove as much cancer tissue as possible. It will be necessary to receive chemo and/or radiotherapy after surgery. The operation involves a larger scar in the back and could be potentially dangerous and should only be performed by skilled surgeons in this field.

Thymoma is an uncommon tumor, best known for its association with the neuromuscular disorder myasthenia gravis Once diagnosed, thymomas may be removed surgically. A biopsy may be done before or during surgery (a mediastinoscopy or mediastinotomy), using a thin needle to remove a sample of cells. This is called a fine-needle aspiration (FNA) biopsy. Sometimes a wide needle is used to remove a sample of cells and this is called a core biopsy. If thymoma is diagnosed, the pathologist will determine the type of cancer cell in the tumor. There may be more than one type of cancer cell in a thymoma. The surgeon will decide if all or part of the tumor can be removed by surgery. In some cases, lymph nodes and other tissues may be removed as well. Chemotherapy may follow the the surgical procedure.