The Scope of Clinical Thoracic Surgery Practice in Nigeria: 13-Year Single Center Review

Abstract

Background: Thoracic surgery as one of the oldest surgical specialties to have branched off from general surgeryhas a relatively wide scope, covering the diagnosis and treatment of the diseases affecting the various regions ofthechest. The practice of this specialty and challenges affecting it in Nigeria is hereby reviewed. Aims/Objective: To review the scope of clinical thoracic surgery practice in Nigeria including its challenges and compare same with international standard. Methods: For a period of 13 years (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019), the practice of clinical thoracic surgery in Nigeria was reviewed with data from the National Cardiothoracic Center of Excellence (NCTCE). The social-demography profile of the involved patients, the congenital and acquired pathologies of the various anatomic regions of the chest, diagnosis and treatmentmethodologies including outcomes and challenges were extracted from the database, reviewed and analyzed. Results: A total of 1883 general thoracic pathologies in 1200 patients were managed. Of this number, pleural pathology accounted for the highest number (n=687, 35.6%). 657 males and 543 females were involved with aM: F ratio of 1:0.8. Of 1883 cases, 1283 (68.1%) had some form of surgical interventions. Within this group, chest tube drainage± pleural biopsy/pleurodesiswasthehighest (n=611, 47.6%). Late presentations of malignant lung diseases, lack of expertise and equipment for minimal access techniques were some of the challenges. Conclusion: General thoracic surgery as a mono-specialty should be embraced, encouraged and upgraded by the training institutions in our sub-region since the workload for experts in the specialty is enormous.