Thoracic Surgery In The Department of Cardiothoracic Surgery

Patient Care

Emphasis on Minimally Invasive Procedures

Thoracic Surgery TeamFrom video-assisted thoracic surgery to laparoscopic procedures and sleeve lobectomies, the Thoracic Surgery Division at Stanford has an overriding goal of imparting a cure with the least invasive procedure available. Patients who come to Stanford have surgical options that are not widely available in the community, or even at many other academic centers. More »

lung tumor

Lung Cancer

We consider excellence in surgery for lung cancer to be at the core of the mission of the Thoracic Surgery service at Stanford. You will be treated at Stanford by thoracic surgeons who are super-specialized in the management of lung cancer and have trained to treat this disease at some of the top thoracic surgery units in the country. We work together with oncologists, radiation oncologists, pathologists, and radiologists at the Stanford Cancer Center to provide a comprehensive approach to therapy. Dr. Joseph Shrager is a surgical lung cancer specialist who is specially trained to perform all of the different types of lung cancer resections that might be required – with the lowest risk and greatest chance of cure. Several studies have now demonstrated that risks are lower and cure rates higher when lung cancer procedures are performed by surgeons, such as those at Stanford, who are specialized in these techniques. We count among our surgeons some of the most experienced lung cancer surgeons in the San Francisco Bay Area and the country. More »

CT-based Lung Cancer Screening

Stanford has begun a CT Lung Cancer Screening Program as a collaboration between our radiologists, pulmonologists, and thoracic surgeons.  CT screening has been shown to reduce mortality from lung cancer in certain current and former cigarette smokers by approximately 50%.  Please see the CT Lung Cancer Screening Program webpage for details on the program and contact information for enrollment.

normal stomachBenign Esophageal Disease

At Stanford, we provide a wide range of minimally invasive surgical treatments for gastroesophageal reflux disease (GERD), achalasia, paraesophageal hernia, and Barrett’s esophagus. Minimally invasive treatments are beneficial because, in some cases, they may eliminate the need for more complex surgeries, and in most cases, minimally invasive treatments reduce the patient's length of hospital stay and shorten recovery time. We have general thoracic surgeons that are specially trained in these methods to treat non-malignant esophageal diseases. More »

mediastinumMediastinal Diseases and Masses / Thymoma

Stanford thoracic surgeons evaluate and treat a high volume and wide variety of mediastinal diseases.  Since many of these lesions are benign, minimally invasive approaches, which allow for less discomfort and faster recovery, can often be utilized.  As in all areas of thoracic surgery, Stanford thoracic surgeons have sub-specialty training in the surgical management of mediastinal tumors and diseases. They have far more experience with these relatively rare diseases than general surgeons and even cardiothoracic surgeons at surrounding community hospitals. For example, in the past year alone, Stanford thoracic surgeons have removed or biopsied 77 mediastinal masses – a very large volume of these cases for a single institution. More »

Sympathetic nerve chainsThoracoscopic (VATS) Sympathectomy for Hyperhidrosis

(also known as Endoscopic Thoracic Sympathectomy or ETS)

Stanford surgeons have performed approximately 150 VATS sympathectomies in the past five years, representing a very extensive experience and demonstrating our significant commitment to the care of patients with hyperhidrosis. Dr. Joseph Shrager has a particular interest in this condition. More »

Lung Volume Reduction Surgery for Emphysema (LVRS)

Lung Volume Reduction SurgeryCurrent medical treatments of emphysema provide a modest degree of palliation, but there is no medical therapy that dramatically improves emphysema patients' shortness of breath or improves their survival. However, Lung Volume Reduction Surgery (LVRS) may be a viable solution for qualifying patients. More »

Esophageal Cancer

Esophageal Cancer imageStanford is the highest volume and highest quality esophagectomy center in the San Francisco Bay Area. Stanford thoracic surgeons have performed 40-60 esophagectomies per year for each of the past several years. There has only been one postoperative death in the past 100 esophagectomies, and our combined morbidity/mortality outcomes, as reported by the Society of Thoracic Surgeons, place our results in the top 15% of those hospitals (mainly major centers of excellence) who choose to report their results. We consider excellence in the surgical management of esophageal cancer, along with management of lung cancer, to be at the core of the mission of the Thoracic Surgery service at Stanford. More »

Pulmonary Metastasectomy

pulmonary noduleA metastasis is a type of lung tumor that develops when cancer from another body site (for example, the breast or colon) spreads to the lung. When this occurs, the tumors in the lung are referred to as metastatic lung (pulmonary) tumors. Because it acts as a sieve for all of the blood that passes through the body, the lung is a very common site for metastatic tumors to lodge.  Fortunately, patients with tumors that spread to the lung from other sites often still have a chance to be cured by surgical removal of these tumors, frequently in combination with chemotherapy. More »

Malignant Pleural Mesothelioma

Malignant Pleural Mesothelioma (MPM) is a rare and aggressive form of cancer that originates in the pleura within the chest cavity. The treatment of MPM depends on the tumor stage, and the patient’s age and overall condition. Treatment strategies for MPM include chemotherapy, radiation, surgery, or a combination of these approaches. At Stanford, we believe in a surgery-based multimodality treatment approach, whenever possible. More »

Chest Wall

Chest wall tumors are uncommon. They can be either benign or malignant. The most common primary malignant chest wall tumors are sarcomas – chondrosarcomas specifically. Metastatic lesions (particularly from breast cancer) can also occur. Usually, the specific diagnosis can be made by a core needle biopsy. Occasionally, however, a firm diagnosis may require an open biopsy. Chest wall resection, with or without removal of adjacent lung tissue, can be done in reasonably straightforward fashion by experienced thoracic surgeons. Chest wall reconstruction may require placement of prosthetic materials and/or rotation of muscle flaps to create cosmetically acceptable and functional results. Patients with chest wall tumors may benefit from evaluation in the Comprehensive Thoracic Oncology Clinic or the Sarcoma tumor board, as multidisciplinary approaches involving surgery, chemotherapy, and radiation therapy may be necessary. Stanford physicians are highly experienced in dealing with these sorts of tumors.

Diseases of the Airway

Diseases of the trachea and major airways are uncommon; however, the Division of Thoracic Surgery has been interested in such diseases for years. Procedures such as tracheal resection, rigid bronchoscopy, laser ablation of tracheal tumors, and tracheal stenting are offered.

VATS LVRSVideo-assisted Thoracic Surgery

Over the last 5-10 years, the field of minimally invasive surgery has expanded dramatically. Initially used primarily by gynecologists, minimally invasive techniques and equipment were adapted for general surgical (abdominal) procedures and subsequently for intrathoracic use of procedures such as pulmonary resection, pleural biopsy, removal of mediastinal tumors, and sympathectomy (for reflex sympathetic dystrophy and hyperhydrosis).
Please see our other sections listed below that highlight use of video-assisted thoracic surgery for the treatment of specific thoracic problems:

The Division of Thoracic Surgery in the Department of Cardiothoracic Surgery at the Stanford School of Medicine is located in the San Francisco Bay Area in northern California. For more information about our services, please contact Donna Minagawa at (650) 721-2086 or Angela Lee, RN, MS, at (650) 721-5402. For new patient Thoracic Surgery Clinic Scheduling, please call (650) 498-6000.

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