Thoracic Surgery Consultative Services

Division Of Basic Sciences - Nci

Investigators

Linked publications, trials & patents

Abstract

The Thoracic Surgery Branch routinely handle referrals from the NCI Surgery Branch, Pediatric Oncology Branch, Surgical Oncology Program, as well as the National Heart, Lung, and Blood Institute, and National Institute of Allergy and Infectious Disease. Thoracic Surgery volumes typically range from 200-250 cases annually, which are covered by three Board-certified thoracic surgeons. The vast majority of cases performed on the Thoracic Surgery Service are high index procedures in patients who have already had multiple surgeries and/or chemotherapeutic regimens or are severely immunocompromised. These procedures include extrapleural pneumonectomies, extended pleurectomy/decortications, mediastinal exenterations with major vascular resections/reconstructions, chest wall resections, complex pulmonary resections and thoracoplasties for primary lung cancers, pulmonary metastases and multidrug resistant resistant mycobacterial or fungal infections, and esophagectomies. The complexity of the cases typically necessitates that two of the three staff surgeons are present, since there are no senior surgical residents to assist. Approximately 60% of all cases performed in the Thoracic Surgery Branch are consult cases; additionally, there are approximately 300 consults annually that do not result in operations in the short term, such as management of pneumothoraces, indeterminant pulmonary nodules, and second opinions. In addition to the aforementioned efforts, TSB also supports training of general surgery residents in the Surgical Oncology Fellowship Program. These residents/fellows rotate on the service for 6-8 weeks, which very frequently represents their first exposure to Thoracic Surgery. Typically, one Surgical Oncology fellow per year chooses to enter the TSB lab for 18-30 months of dedicated research training; these individuals have consistently tracked to top-tier Thoracic Surgery residency programs and subsequent faculty appointments at leading medical centers in the United States. TSB staff are also actively engaged in weekly SOP clinical QA meetings as well as monthly Morbidity/Mortality conferences thus fulfilling our mission to help train the next generation of surgeon-scientists.