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INTRODUCTION

Thoracic surgery is a rapidly evolving field that has witnessed significant advancements and innovations in recent years. With the advent of new therapeutic strategies, improved surgical techniques, innovations, and a deeper understanding of thoracic anatomy and physiology, thoracic surgeons are now able to provide better outcomes and a higher quality of life for their patients. The objective of this chapter is to examine pertinent diseases and present a comprehensive overview of the present status of thoracic surgery, emphasizing the most recent advancements, treatments, and techniques that are revolutionizing the field. In this introduction, we will provide a brief overview of some of the principal developments in thoracic surgery.

Notable progress has been made in the techniques used to diagnosis and treat lung cancer. Preoperative computed tomography (CT)–guided fiducial markers have contributed to those improvements. Placed for the localization of lung nodules, fiducial markers have resulted in a surgical localization failure rate of 0.5%. Recently, liquid biopsy has emerged as a promising alternative to tissue biopsy in the diagnosis and treatment of lung cancer. By utilizing a range of biomarkers, including circulating tumor cells (CTCs), cell-free DNA (cfDNA), and circulating tumor DNA (ctDNA), this technique allows for the monitoring of disease progression and treatment response over time, which can help guide treatment decisions.

One of the several significant advancements in thoracic surgery has been the widespread adoption of minimally invasive techniques, with shorter hospital stays and faster recovery times. Further aided by use of robotic-assisted surgery, this addition to minimally invasive surgery allows for a greater precision and control, particularly effective for complex lung resections and esophagectomies, with reduced blood loss, shorter hospital stays, and improved surgical outcomes. Robotic bronchoscopy is another novel technique gaining traction in the field of thoracic surgery. A key benefit of robotic bronchoscopy is its ability to reach areas within the airways that are challenging or inaccessible through conventional bronchoscopy methods.

In recent years, there has also been a greater focus on personalized medicine in thoracic surgery. This involves tailoring treatments to the individual needs of each patient based on their unique medical history, genetic makeup, and other factors. Advances in imaging technology, such as CT scans and positron emission tomography (PET) scans, have made it possible to better identify the location and extent of tumors and other abnormalities in the thoracic cavity, allowing for more targeted and precise surgical treatments.

Lastly, significant progress has been made in the area of thoracic oncology, with notable advancements in novel immunotherapy and targeted therapy. Targeted therapy is a type of treatment that uses drugs or other substances to attack specific cancer cells without harming healthy cells. In the case of lung cancer, targeted therapies are frequently utilized to treat tumors that possess particular genetic mutations, such as EGFR or ALK mutations. These medications are capable of hindering the growth and spread of cancer cells and improve outcomes ...

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