The present situation, breakthrough and challenge in the development of thoracic surgery

A new journey towards precise and efficient clinical services

Abstract

The incidence and mortality of lung cancer and esophageal cancer in China are among the top in the world. Most patients have reached the middle and late stage when diagnosed. The five-year survival rate of lung cancer is only 16%, and that of esophageal cancer is less than 20%. Obviously, early diagnosis and treatment is the key to improve the survival rate of patients, and the healthy development of thoracic surgery plays an important role in improving the quality of life of patients with chest tumors.

At present, the field of thoracic surgery is being strongly driven forward by ten key directions. "Surgical robot digital medical" integrates top technology, high-precision robotic arm and intelligent imaging system, making surgical operation accurate and micro, opening up a new situation for the treatment of complex diseases; "Lung Transplant Surgery Practice" to overcome the problems of lung source acquisition, surgical anastomosis, anti-rejection, for patients with end-stage lung disease to continue life. "Accelerated rehabilitation surgical process management" runs through the whole perioperative period, fine-adjusting fasting and drinking, precise analgesia, and encouraging early activities of patients to shorten hospital stay and improve medical experience. "Fine control of Medical quality" strictly controls all aspects of medical treatment, standardizes the diagnosis and treatment process with high standards, supervises medical behavior, and ensures that patients receive homogeneous, efficient and safe services; "Multidisciplinary collaborative diagnosis and treatment" breaks the disciplinary barriers, integrates the wisdom of internal medicine, surgery, imaging, pathology and other professionals, and tailors the best comprehensive treatment plan for difficult and complicated diseases; "Perioperative health management model construction" covers the whole surgical cycle, accurate preoperative assessment, careful care during the operation, and continuous follow-up after the operation to help patients smoothly through the surgical period. "Tumor comprehensive treatment strategy" gets rid of the shackles of single therapy, organically combines surgery, chemotherapy, radiotherapy, targeting, immunity and other therapeutic means, and develops a personalized anti-cancer path according to tumor characteristics and individual differences of patients. "Minimally invasive surgical operation technology" with the aid of small incisions and endoscopy can reduce the pain of patients while accurately removing lesions and accelerating recovery. The "Young Doctor Training System" cultivates reserve talents with both morality and talent through systematic training, tutor teaching and practical exercise. "Cutting-edge Medical Technology integration Application" advocates cross-field technology integration, such as bioprinting and tissue repair, artificial intelligence assisted diagnosis, etc., to promote medical innovation.

However, the road to thoracic surgery has been rocky. On the one hand, the busy clinical work makes the data collection more quantity than quality, the database repeated entry, low efficiency, incomplete data and poor sharing, and the national unified database that meets international standards is still lacking, which restricts the healthy development of the discipline. On the other hand, the problem of domestic scholars' papers emphasizing quantity over quality still exists, and some lack of innovation, difficult to solve clinical practical problems, low citation rate, and difficult to transform basic research. Moreover, the domestic guidelines do not consider the local characteristics, and the self-developed guidelines lack channels and mechanisms for promotion. In addition, there are still problems such as uneven distribution of medical resources, large gap between urban and rural areas, low urban-rural integration of multidisciplinary diagnosis and treatment mode, and limited comprehensive diagnosis and treatment level.

Despite the difficulties, thoracic surgery has made many achievements with the help of modern technology. Looking forward to the future, practitioners need to work together to tap the potential of data, improve the level of scientific research, improve and promote clinical guidelines, narrow the gap between urban and rural medical care, promote thoracic surgery to a new height, inject great strength for "Healthy China 2030", and provide patients with better medical services