MUSC thoracic surgeons work closely with the Digestive Disease Center in the critical staging component of treatment planning. We discuss surgical options as these relate to each patient’s characteristics. We also review palliative options, such as stenting, laser and photodynamic therapy. MUSC has a special interest in Barrett’s esophagus (a change in the lining of the esophagus due to chronic gastroesophageal reflux). We have a surveillance clinic and a variety of treatment techniques available. For patients with high-grade dysplasia (a precancerous condition), we collaborate on individualized treatment options, including participating in cutting-edge clinical trials. Mesothelioma
Mesothelioma is a cancer of the lining of a body cavity. It can occur in the chest or in the abdomen. Most cases of mesothelioma are caused by exposure to asbestos. Treatment of mesothelioma usually consists of a three-part therapy, including surgery to remove the tumor, chemotherapy and radiation. The best survival rates for patients with mesothelioma occur when the tumors are in the early stage. Chest Wall Tumors
Benign and malignant chest wall tumors occur on the ribs or sternum. Surgery for these tumors involves removing a portion of the rib cage and reconstructing it with a synthetic material to provide structure and substance to the chest wall. Chest wall tumors are uncommon, but they can occur in people of all ages. Tumors of the Mediastinum
Tumors of the mediastinum include thyroid goiters; tumors of the thymus gland, or thymomas; and lesions involving the nerves near the spine. Depending on the location of the tumor, minimally invasive thoracosopic surgery may be an option. Some of these tumors require full incisions, however. Tracheal Cancer
Within the trachea or wind pipe, benign and malignant tumors can develop in the mucosal lining or the tracheal wall itself. Some types of tracheal cancer are associated with smoking and others have no known cause. Due to the proximity of the trachea to a variety of other organs, it can become a secondary site for tumors that develop in nearby organs, such as the thyroid or esophagus. The best treatment for tracheal cancer is surgical removal of the tumor. This is a very complex operation that requires the specialized training of surgeons who concentrate their practice in thoracic surgery. Gastroesophageal Reflux Disease (GERD)
Gastroesophageal reflux disease and other esophageal problems affect thousands of people in the United States. Patients with GERD frequently complain of heartburn and a sour taste in the back of their mouths. They can also suffer complications, such as pneumonia, cavities in their teeth and bad breath. Most patients can be treated with medicines to reduce the acid produced by the stomach. For those who have persistent symptoms even while taking medication, surgery is recommended to treat the disease. During the operation, a hiatal hernia is repaired and the top portion of the stomach is wrapped around the base of the esophagus to create a new valve that prevents reflux. In most cases, the operation can be performed using a minimally invasive technique. Achalasia
Achalasia is a swallowing disorder caused by a blockage at the bottom end of the esophagus, just before it goes into the stomach. At that point, there is a tight muscle known as the lower esophageal sphincter, which normally relaxes when we swallow food. In patients with achalasia, this muscle is abnormal and does not relax to allow the passage of food. Patients experience difficulty in swallowing, weight loss and the regurgitation of undigested food that backs up into their esophagus. While there are several options in treating achalasia, the most long-term solution is surgery. The operation consists of cutting the muscle at the end of the esophagus to allow food to pass easily into the stomach. This operation is a good candidate for minimally invasive techniques. Sympathectomy
MUSC thoracic surgeons perform a procedure known as sympathectomy to treat hyperhidrosis, or heavy sweating. This socially devastating problem is characterized by heavy or constant sweating on the palms or in the armpits. Sympathectomy involves cauterizing (cutting and sealing) a portion of the sympathetic nerve chain that runs down the back, inside the chest and parallel to the spine. The operation permanently interrupts the nerve signal that causes the body to sweat excessively. | 
