Our Summary

This research paper examines how changes in rules and techniques over the past 20 years have affected training in thoracic surgery (surgery involving the chest) for general surgery residents in the United States. To study this, the researchers looked at records of surgery cases handled by these residents from 1999 to 2019. They specifically looked at cases involving the chest area, including heart, blood vessel, pediatric, trauma, and digestive system procedures. They divided the data into four 5-year periods for comparison.

The results show that overall, there has been a slight increase in chest surgery experience among general surgery residents. There’s been a significant increase in experience with thoracoscopic surgery - a less invasive technique that uses a camera and small instruments inserted through small cuts. Meanwhile, experience with traditional open chest surgery has significantly decreased. There was also a minor decrease in the number of chest trauma procedures performed.

These changes reflect the general shift in surgery towards less invasive techniques. The findings suggest that training for general surgery residents is keeping pace with these changes in surgical practice.

FAQs

  1. How has the training in thoracic surgery for general surgery residents in the United States changed over the past 20 years?
  2. What specific types of surgical procedures were analyzed in this research study?
  3. Based on the research, how has experience with thoracoscopic surgery and traditional open chest surgery changed among general surgery residents from 1999 to 2019?

Doctor’s Tip

A helpful tip a doctor might give a patient about thoracic surgery is to closely follow all pre-operative instructions provided by the surgical team. This may include fasting before surgery, stopping certain medications, and avoiding smoking or alcohol. Adhering to these instructions can help minimize the risk of complications during and after the surgery. Additionally, it’s important for patients to communicate any concerns or questions they may have with their surgical team to ensure a successful outcome.

Suitable For

Patients who may be recommended for thoracic surgery include those with conditions such as lung cancer, esophageal cancer, mediastinal tumors, chest wall tumors, empyema (infected fluid in the chest), pleural effusions (excess fluid around the lungs), hiatal hernias, and thoracic outlet syndrome. Additionally, patients with certain cardiovascular conditions such as coronary artery disease, aortic aneurysms, and valve disorders may also require thoracic surgery.

It is important for patients to consult with their healthcare provider to determine if thoracic surgery is the appropriate treatment option for their specific condition. Thoracic surgeons are highly specialized and trained to perform procedures in the chest area, and they work closely with a multidisciplinary team to provide comprehensive care for patients undergoing thoracic surgery.

Timeline

  • Before thoracic surgery:
  1. Patient consults with a thoracic surgeon to discuss the need for surgery and potential risks and benefits.
  2. Patient undergoes pre-operative tests and evaluations to assess their overall health and suitability for surgery.
  3. Patient may need to make lifestyle changes or stop certain medications in preparation for surgery.
  4. Patient receives instructions on how to prepare for surgery, including fasting before the procedure.
  5. Patient arrives at the hospital on the day of surgery and is prepped for the procedure.
  • After thoracic surgery:
  1. Patient wakes up in the recovery room and is closely monitored for any complications.
  2. Patient may experience pain and discomfort at the surgical site, which is managed with pain medication.
  3. Patient is encouraged to start moving and walking to prevent complications such as blood clots.
  4. Patient may need to undergo physical therapy to regain strength and mobility.
  5. Patient is discharged from the hospital once they are stable and able to care for themselves at home.
  6. Patient follows up with their surgeon for post-operative appointments to monitor their recovery and address any concerns.

What to Ask Your Doctor

Questions a patient should ask their doctor about thoracic surgery include:

  1. What specific type of thoracic surgery procedure is recommended for my condition?
  2. What are the risks and potential complications associated with the surgery?
  3. How experienced is the surgeon in performing this type of surgery?
  4. What is the expected outcome and recovery time for this surgery?
  5. Will I need any additional tests or consultations before the surgery?
  6. What are the alternative treatment options to surgery for my condition?
  7. How will pain management be handled during and after the surgery?
  8. What post-operative care and rehabilitation will be required?
  9. What is the success rate for this type of surgery in treating my condition?
  10. Are there any long-term effects or considerations I should be aware of after the surgery?

Reference

Authors: Blitzer D, Benintende AJ, Nemeth S, Kurlansky P, Antkowiak M, Fischkoff K, Argenziano M, Takayama H. Journal: Am Surg. 2023 Dec;89(12):5512-5519. doi: 10.1177/00031348231157417. Epub 2023 Feb 16. PMID: 36797046