Thoracic surgery in Peshawar

Background

Thoracic surgery in Peshawar

Thoracic surgery is the smallest of the three services here and the most specialised. It deals with the organs inside the chest and the structures that contain them: the lungs and airways, the pleural space around them, the bony chest wall, the diaphragm below, and the esophagus running through to the stomach.

A large share of the workload in this region is infective rather than oncological. Tuberculosis leaves behind trapped lungs, thickened pleura and empyema cavities that need surgical drainage and decortication, and these patients are often referred late, after months of medical treatment has failed to re-expand the lung.

The rest divides between tumors needing resection, congenital chest wall deformities in young people, and problems at the junction of the chest and abdomen — hiatus hernia, diaphragmatic defects and esophageal disease. Assessment for all of these rests on CT imaging and on whether the patient will tolerate the operation.

Chest surgery depends on lung reserve as much as on the lesion. Lung function testing and CT come before any resection is planned, because the question is not only what can be removed but what the patient can manage without.