The 2021 report of surgical activities at one of the world’s premier thoracic surgical centers (1) stops a Western reader in his tracks. There is no institutional comparison to the sheer depth of experience in a single year, a collection of operations that by their number would serve as a unique accomplishment for a generation of surgeons anywhere else. Those who visit the Shanghai Chest Hospital, even for a day, leave impressed by one day’s operative schedule and wish to understand the remarkable organization that enables a growing procedural volume year after year, hardly slowed by a pandemic. Who are the people creating a high reliability organization of this magnitude, how do they interact to form their communality of purpose, how do they educate the next generation and how does their clinical work translate into research? To the observer from afar, their report raises so many interesting questions.
The trends in pulmonary resection observed at Shanghai Chest Hospital illustrate ongoing developments seen elsewhere in our specialty. Segmentectomy is on the rise, lobectomy diminishing, complex operations and extended resections are waning to the point of becoming rare, and within strong growth of minimally invasive methods their surgeons currently favor thoracoscopy over robotic assisted procedures. Lung cancer is a different disease now, and one important reason are the screening processes that help in the transition of surgical care from tertiary to successful secondary disease prevention. How referrals of this scale enter the hospital gates and how public or private screening programs are organized and coordinated with the surgical staff is of tremendous interest to the practicing surgeon as we learn to adapt to a new age.
The significance of the Shanghai Chest Hospital could never be appropriately expressed in numbers alone. We are curious to learn in the future how the next generation of thoracic surgeons is educated, and translational research realized, at such a vibrant institution.
Provenance and Peer Review: This article was commissioned by the editorial office, Shanghai Chest. The article did not undergo external peer review.
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- Wang Y, Gu Z, Yao F, et al. Annual report of thoracic surgery service at Shanghai Chest Hospital in 2021. Shanghai Chest 2023;7:15. [Crossref]
Cite this article as: Gaissert HA. Shanghai Chest Hospital: the story yet to be told. Shanghai Chest 2023;7:21.