Chest Surgery
Division of Chest Surgery treat patients with lung cancer, esophageal cancer, mediastinal tumors and other thoracic cancers and benign tumors. We also treat patients with benign diseases including pneumothorax, empyema and perform lung transplantation for patients with end stage benign lung diseases. We provide Individual treatment for patients of early lung cancer with novel method for accurate pulmonary nodules localization
Overview
Screening with the use of low-dose computed tomography can reduce mortality from lung cancer, by 20-33% in high-risk populations. Aggressive adoption of low-dose chest CT scan increases the increase of early lung cancer detection rate. For early-stage lesions, parenchymal-sparing resection for lung function preservation is an alternative treatment for certain groups without compromised oncological outcome.
Features
We have provided many methods for accurate localization of pulmonary nodules, including:
1.Pre-operative localization in CT room by interventional radiologists
2.Electromagnetic navigational (EMN) technology
3.Intra-operative mobile CT
4.Cone-beam CT in hybrid operation room
★Taipei Veterans General Hospital had experience of more than 2,000 cases on localization of pulmonary lesions in CT room. Successful rate is over 97.5%.
★Localization of pulmonary lesions under electromagnetic navigational system at Taipei Veterans General Hospital are more than 160 experiences, which is the top one in Asia. Taipei Veterans General Hospital is also the only center of excellence in Asia.
★With these, we also won 2022 SNQ (Symbol of National Quality) bronze award from the Institute of Biotechnology and Medicine Industry.
★Experiences of localization via intra-operative mobile CT is over 50 cases, the resection rate is 100%, which is the top one in the world.
Procedure
Pre-operative: Preoperative preparations include disease medical condition explanation, preoperative anesthesia visits, and deep breathing exerciser training.
Surgery:
Pulmonary nodules will be localized by chest surgeons or radiologists, then minimally invasive video assisted thoracoscopic surgery (VATS) is performed under general anesthesia or non-intubated under heavy sedation. Localized lesions will be recognized and successfully resected under marking.
The VATS approach has proven to be superior to thoracotomy in many regards. The VATS approach can be performed via multiple ports, usually 2–4 incisions without rib spreading to evolve to single-port approach.
In Taipei Veterans General Hospital, the evolution of the thoracoscopic surgery has moved to less invasive techniques. Uniportal VATS had been developed for many years. Currently, uniportal VATS followed by localization is a routine procedure for patients with small ground glass opacity, which may reduce postoperative pain and lead to faster recovery. Complications of surgery are minimal, which resulted in early mobilization and decreased hospital stay.
For patients with old age or limited pulmonary function, alternative treatment methods can be provided in our hospital. Cryoablation is a procedure that utilizes cold liquid nitrogen to treat cancer. Accurate localization is also applied on cryoprobe
to freeze the tissue.
Post-operative:
# Daily wound care
# Adequate pain control
# Chest drainage tube care
# Encourage ambulation
Notification
Risks and complications associated with VATS surgery include:
# Bleeding
# Wound pain/infection/poor healing
# Pneumothorax/hemothorax/chylothorax
# Pneumonia/sepsis/respiratory failure/shock
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.