Peter F.
Crookes, M.D.

Steven R.
DeMeester, M.D.

Jeffrey A.
Hagen, M.D.

John C. Lipham,
M.D.

Farzaneh.
Banki, M.D.

Thoracic surgery encompasses surgery on the chest wall and organs contained within the thoracic, or chest, cavity. The foregut includes the esophagus, stomach, and proximal small intestine. Together, these organs work to prepare food and fluids for absorption by the remainder of the bowel, and to prevent reflux of gastric acid, bile, and pancreatic secretions backwards into the esophagus. Often times correcting a disorder of one of these organs requires restructuring or altering one or more of the other foregut organs. Consequently, we believe the surgeons working with foregut problems should not try to divide problems between those in the chest and those in the abdomen. Rather, we approach the foregut as a unit, and are comfortable working on both sides of the diaphragm to correct the pathophysiology of the disease process.

Surgeons within the Thoracic and Foregut Division are members of the Department of Surgery and the Department of Cardiothoracic Surgery at the University of Southern California. Areas of expertise by members of this group cover all aspects of chest wall, mediastinal, pulmonary, tracheal, esophageal, and upper abdominal surgery. Committed to the wisdom of careful diagnosis proceeding treatment, we utilize state of the art esophageal and pulmonary function laboratories along with radiographic imaging including CT, MRI, and PET scans to define the problem and determine the best therapy. Operative approaches are individualized for each patient and condition, but often are performed using advanced laparoscopic or thoracoscopic (minimally invasive) techniques.

Esophageal Surgery Gastroesophageal Reflux Disease: Primary and redo antireflux surgery, laparoscopic fundoplication, Barrett's esophagus, intestinal metaplasia of the cardia, esophagitis, esophageal stricture, and hiatal hernia. Esophageal Motor Disorders: Achalasia, diffuse esophageal spasm, nutcracker esophagus, scleroderma, hypertensive lower esophageal sphincter, and cricopharyngeal dysfunction. Diverticula: Zenker's, epiphrenic, traction and pulsion. Benign Tumors: Leiomyoma. Malignant Tumors: Adenocarcinoma, squamous cell carcinoma. Infections, Performations, Caustic Injury Stomach and Duodenum Peptic Ulcer Disease: Gastric ulcer, duodenal ulcer, Zollinger-Ellison syndrome, and Helicobacter pylori infection. Motility Abnormalities: Diabetic gastroparesis, delayed gastric emptying, bile reflux gastritis, dumping syndrome. Gastric Tumors: Leiomyoma, sarcoma, and adenocarcinoma. Duodenum: Diverticulum, ulcer, and tumors

Thoracic Surgery Chest Wall: Benign and malignant tumors of the ribs, sternum, and muscles of the chest wall, bony defects of the chest wall such as pectus excavatum and pectus carinatum, thoracic outlet syndrome, hyperhidrosis, reflex sympathetic dystrophy, lung hernia, and stabilization of the chest after trauma. Pleural Disorders: Pleural effusion, empyema, and tumors of the pleura. Pulmonary Disorders: Lung cancer, lung metastasis, pulmonary nodules, carcinoid tumors, hamartomas, emphysema, giant bullas disease, spontaneous pneumothorax, sequestration, hemangiomas, arterial-venous fistulas, and infections. Tracheal / Bronchial Disorders: Tumors and strictures of the trachea including those involving the subglottic larynx or carina, extrinsic tracheal compression, tracheal malacia, sarcoidosis, Wegener's granulomatosis, tracheostomy, bronchial stenosis, and bronchiectasis. Mediastinal Disorders: Mediastinal tumors and cysts, thymoma, teratoma, thymectomy for myasthenia gravis, neurogenic tumors, germ cell tumors, mediastinitis, chronic fibrosing mediastinitis, and mediastinal lymphadenopathy. Disorders of the Diaphragm: Eventration, hernia, and phrenic nerve paralysis.