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  • Title: The Advent of Ultra-high Volume Thoracic Surgical Centers in Shanghai.
    Author: Sihoe ADL, Han B, Yang TY, Pan C, Jiang G, Fang VWT.
    Journal: World J Surg; 2017 Nov; 41(11):2758-2768. PubMed ID: 28608012.
    Abstract:
    BACKGROUND: A core principle in surgery is that high surgical volumes are conducive toward better outcomes. Ultra-high volume centers (UHVCs) have now emerged in thoracic surgery in China that now perform a volume of thoracic operations far greater than even traditional international centers of excellence. METHODS: In 2016, two hospitals in Shanghai performed over 10,000 major pulmonary, esophageal and mediastinal resections each. A qualitative analysis of the lessons learned in achieving such large operation volumes was undertaken. RESULTS: The advent of these UHVCs gives important insights for not only thoracic surgeons, but for surgical oncologists and surgeons globally. First, these ultra-high volumes were achieved to a large degree by cancer screening-but the success of the screening programs relies on reaching wider patient groups and allowing for affordable 'self-screening.' Second, the ultra-high clinical volumes at UHVCs offer unique opportunities for surgical training and research, potentially changing paradigms for academic surgery. Third, these ultra-high volumes may place new stresses on existing healthcare resources and prompt novel management strategies in response. CONCLUSIONS: The UHVCs represent a revolutionary development in modern surgery, and it behooves surgeons to both accept the challenges and harness the advantages they may bring.
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