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Thoracic Surgery

More than 300 surgical treatments per year for the chest diseases including the lung, pleura, mediastinum and chest wall and lung transplantation are performed in this department.

Medical services

A staff team including 6 board-certified thoracic surgeons provides surgical treatment for lung cancer and other neoplastic diseases of the lung, mediastinum, pleura, and chest wall, collaboratively with pulmonologists and radiologists.
In 2014, we started lung transplantation program for patients suffering from end-stage diffuse lung diseases refractory to conventional medical therapies.
We also treat non-neoplastic diseases of the chest, including pulmonary inflammatory disorders, pneumothorax, pulmonary emphysema, funnel chest, hyperhidrosis, and myasthenia gravis.

Diagnosis and treatment policy

We apply the evidence-based medicine (EBM) and minimally invasive techniques to patients suffering from thoracic diseases.

Specialized surgical procedures include:

  • Thoracoscopic surgery for lung cancer: A standard surgery for lung cancer, i.e., lobectomy and mediastinal lymph node dissection is routinely performed through thoracoscopy in our department. Almost all of other thoracic surgeries are done through thoracoscopy.
  • Extended resections and reconstructive surgeries for advanced lung and mediastinal malignancies are also performed in our department.
  • Thoracoscopic diagnosis for indeterminate pulmonary or mediastinal diseases (VAL-MAP)
  • Lung transplant: Lung transplantation from living and brain-dead donors for severe diffuse pulmonary disease has been performed since FY2015. 42 patients underwent lung transplantation in 2023.
  • Robot-assisted surgery: Robot-assisted surgery using “da Vinci” is performed for lung cancer and mediastinal tumors with the same degree of sensitivity and accuracy as thoracoscopic surgery.

Target diseases

Primary lung cancer, pulmonary metastasis, other lung tumors, thymoma, other mediastinal tumors, pleural mesothelioma, chest wall tumor, spontaneous pneumothorax, pulmonary mycosis, pulmonary atypical mycobacteriosis, pulmonary emphysema, funnel chest, hyperhidrosis, and thoracoscopic pulmonary biopsy for pulmonary abnormal shadow and diffuse pulmonary diseases

Advanced treatments/ Specialized treatments

  • Complete thoracoscopic lobectomy for early-stage lung cancer
  • Lung transplantation
  • Virtual assisted lung mapping (VAL-MAP) for detecting intrapulmonary small lesion

Frequently performed tests and descriptions

Outpatients
  • Bronchoscopy, Endobronchial Ultrasound (EBUS)
  • CT, MRI, FDG-PET
Inpatients
  • Thoracoscopic pulmonary biopsy
  • CT-guided percutaneous needle biopsy (A biopsy needle is inserted through the chest wall under CT guidance for diagnosis of lung and mediastinal tumors.)
  • Inpatient examination for lung transplant assessment

Major diseases and numbers of inpatients treated

Disease name Number of inpatients
1 Primary pulmonary cancer 121
2 Metastatic pulmonary tumors 44
3 Mediastinal tumors 26
4 Myasthenia gravis 2
5 Spontaneous pneumothorax 23
6 Pleural and chest wall tumors 12
7 Infectious pulmonary diseases 14

(2014)

Areas of expertise, treatment and examination methods

Diseases
  1. Primary pulmonary cancer
  2. Metastatic pulmonary tumors
  3. Mediastinal tumors and myasthenia gravis
  4. Spontaneous pneumothorax
  5. Pleural and chest wall tumors
  6. Progressive diffuse pulmonary disease requiring lung transplantation
Treatment methods
  1. Low-invasive thoracoscopic surgery for pulmonary cancer and metastatic pulmonary tumors
  2. Extended surgery for advanced pulmonary cancer
  3. Surgical treatment of mediastinal tumors, particularly thymic tumors and myasthenia gravis
  4. Thoracoscopic surgery for benign pulmonary diseases
  5. Live donor lung transplantation, deceaesed donor lung transplantation
Examination methods
  1. Image-based examination combining CT and FDG-PET scanning for pulmonary cancer and metastatic pulmonary tumors
  2. Treatment of small tumors in the lungs through thoracoscopic diagnosis and simultaneous surgical procedures by Virtual Assisted Lung Mapping
  3. Thoracoscopic lung biopsy for diffusive pulmonary diseases
  4. Examination of EGFR gene mutation in pulmonary cancer
  5. Evaluation for lung transplantation

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