Annual report of thoracic surgery services at the Shanghai Chest Hospital in 2020

Abstract

Background:The thoracic surgery team of the Shanghai Chest Hospital has been publishing its annual report since 2018, summarizing the services and major progress over the last year.Methods: All patients receiving thoracic surgery services at the Department of Thoracic Surgery and the Department of Oncological Surgery at the Shanghai Chest Hospital in 2020 were enrolled. The number of surgical resections, types of surgical procedures, disease histological types, and perioperative outcomes were collected and compared with the results from previous years.Results: In the year 2020, the thoracic team of the Shanghai Chest Hospital faced the unprecedented challenge of the coronavirus disease 2019 (COVID-19) epidemic. A total of 15,664 patients received thoracic surgeries at the Shanghai Chest Hospital, only an 8.0% decrease compared with the previous year of 2019.These included 13,493 pulmonary procedures, 1,075 esophageal procedures, 969 mediastinal procedures, 66 tracheal procedures, 2 lung transplantations, and 59 other procedures. The rate of minimally invasive surgeries among all procedures was 91.1%, including 721 robotic-assisted thoracic surgeries, both of which increased from the year before. In addition, the average length of hospital stay continuously decreased, being only 3.82 days after pulmonary surgery and 10.96 days after esophageal surgery. Meanwhile, the quality of thoracic surgery has improved, with continuously lower rates of perioperative complications and an inhospital mortality rate of only 0.14%. Conclusions:The services provided and progress made in 2020 by the thoracic surgery team of the Shanghai Chest Hospital were reviewed in this annual report, reflecting a consistent effort to help our patients with high-standard services and state-of-the-art surgical techniques.

Minimally invasive sleeve lobectomy for centrally located lung cancer: A real-world study with propensity-score matching

“…In the real-world, the application of MIS for sleeve lobectomy was still much less often used than open thoracotomy even at a highvolume thoracic surgery center. According to the annual report of the Shanghai Chest Hospital, the overall MIS rate for lung surgery was over 95% (32), but the MIS rate for sleeve lobectomy was only 17.8% in our study during the same time period. As a technically demanding procedure, surgeons tended to perform MIS sleeve lobectomy for smaller tumors in earlier stages or less complex right upper lobe sleeve lobectomy, as was shown in our study.…”

Surgical Outcomes of Video-Assisted versus Open Pneumonectomy for Lung Cancer: A Real-World Study

“…The proportion of VATS among all pneumonectomies increased from merely 10% to 40% during the study period, along with the increasing use of minimally invasive surgery for all lung cancer procedures. However, it was still much lower than the use of minimally invasive surgery for lesser resections (18.0% vs. 95.2%, p = 0.000) [ 15 ]. Although mean operation time was longer in the VATS group than in the Open group, it has gradually dropped from 266 min at the beginning to about 180 min at the end of the study period, while the mean operation time (140 min) for Open pneumonectomy remained stable throughout the entire study period ( Figure 1 ).…”

“…Although the first case of VATS pneumonectomy was accomplished in the early 1990s [ 6 ], application of VATS in pneumonectomy remains limited. Even in Shanghai Chest Hospital, one of the largest thoracic surgery units in the world, the application of VATS in pneumonectomy was still much less frequent than in lesser resections [ 15 ]. However, with the accumulation of experience, that figure has increased from less than 10% before 2015 to nearly 40% at the end of the study.…”

“…It was associated with a decreased overall complication (8.2% vs. 16.7%, p = 0.088) and a trend toward faster recovery for shorter day in ICU and LOS, showing its potential benefit over open approach. On the contrary, right pneumonectomy is known to be associated with more postoperative complications [ 15 , 22 ]. But there have not been any studies on whether this increased risk could be reduced by the use of minimally invasive approach.…”

Theoretical study on the effective thermal conductivity of silica aerogels based on a cross-aligned and cubic pore model

“…Due to its unique microstructure, it holds 15 Guinness World Records for solid materials, including the lowest thermal conductivity (0.012-0.016 W/m•K), lowest density (0.16 mg/cm 3 ), lowest dielectric constant (< 1.003), highest acoustic impedance (106 kg/(m 2 •s)), and highest porosity (> 99.9%). [1,2] The critical electrical components and wiring of China's first Mars rover, Tianwen-1, as well as China's Zhurong rover, and the American Mars rovers, Spirit and Opportunity, all use aerogel protection to withstand temperatures as low as −100 • C. [3] The main reasons for the extremely low thermal conductivity of aerogels are twofold: the first is the high porosity of aerogels, with the porosity of silica aerogels ranging from 90% to 99%, and the volume fraction of air being as high as approximately 99.8%. [4] Heat transfer within aerogels mainly occurs through the air, and the thermal conductivity of air in standard conditions is 0.024 (W/(m•K)); the second reason is the restriction on the thermal motion of gas molecules.…”