Making a Difference in Surgery

Authors

  • Alan D. L. Sihoe Honorary Consultant in Cardio-Thoracic Surgery, Gleneagles Hong Kong Hospital

Abstract

When asked what motivates them in their work, one commonly given answer by many doctors and surgeons is the feeling that they are “making a difference” for their patients. Surgery uniquely
rewards those who practice it diligently with the satisfaction that their efforts can directly determine the difference between life or death, wellness or suffering for those they care for.
It follows that conscientious surgeons strive to constantly improve their craft, so that they can make even greater differences in outcomes. For many surgeons around the world, inspiration for such improvements can usually be found in the pages of quality surgical journals – such as Esculapio. In such journals, reports of the latest clinical and academic research are mixed with descriptions of how interesting diseases and patients were managed. Presentations of major trial findings at international surgical meetings are another rich source of new knowledge. For those looking for clues to self- improvement, the most readily appreciated articles and presentations are often those that describe the latest surgical techniques and technology. These are cornerstones of modern surgical practice, and it makes sense that the modern surgeon is most easily attracted by the newest developments in these areas. However, it is perhaps time for surgeons to pause and recalibrate. Exciting as they may be, are advances in techniques and technology really the best way to make a difference in surgery today? Or are there other less glamorous– but perhaps more effective – ways in which surgeons can improve the lot of their patients? In addressing this question, let us consider the author's specialty: Thoracic Surgery. Over the past year, what were the studies that really had the
potential to allow thoracic surgeons to make a better difference?

Author Biography

Alan D. L. Sihoe, Honorary Consultant in Cardio-Thoracic Surgery, Gleneagles Hong Kong Hospital

MBBChir, MA(Cantab), FRCSEd, FCSHK, FHKAM, FCCP, FACS

Honorary Consultant in Cardio-Thoracic Surgery, Gleneagles Hong Kong Hospital

References

Todd B. Can one person change the world? What the evidence says. 80,000 Hours (2016). Available at: https://80000hours.org/career-guide/can-one-person- make-a-difference/. Accessed on: 16 January 2022.

Asamura H, et al. Randomized trial of segmentectomy compared to lobectomy in small-sized peripheral non- small cell lung cancer (JCOG0802/WJOC4607L). Presented at: 101st Annual Meeting, American Assocation for Thoracic Surgery, April30 - May 2,

Sihoe ADL. The Impact of the JCOG0802 Trial on Lung Cancer Surgery. Presented at: 2021 Belgian Surgical Week, Royal Belgian Society of Surgery, 9- 11 September 2011.

Sihoe ADL. The Evolution of Video Assisted Thoracic Surgery. In: Atlas of Uniportal Video Assisted Thoracic Surgery. Gonzalez Rivas D, Ng CSH, Rocco G, D'Amico T (Eds). Springer Science, Berlin, Germany, 2019: 3-15.

Sihoe, ADL. Video‐assisted thoracoscopic surgery as the gold standard for lung cancer surgery. Respirology 2020; 25: 49– 60

Sihoe D.L.A. Uniportal video assisted thoracic surgery (VATS) lobectomy, Ann Cardiothorac Surg,

; 5:133-144.

Sihoe ADL. Uniportal Lung Cancer Surgery: State of the Evidence. Ann Thorac Surg 2019;107:962-72.

Gao S, et al. Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery. Transl Lung Cancer Res. 2019 Dec;8(6):1174-1187.

Wakelee HA, et al. IMpower010: Primary results of a phase III global study of atezolizumab versus best supportive care after adjuvant chemotherapy in resected stage IB-IIIA non-small cell lung cancer (NSCLC). Journal of Clinical Oncology 2021

:15_suppl, 8500-8500.

U.S. Food and Drug Administration. FDA approves atezolizumab as adjuvant treatment for non-small cell lung cancer (Oct 15 2021). Available at: https://www.fda.gov/drugs/resources-information- approved-drugs/fda-approves-atezolizumab- adjuvant-treatment-non-small-cell-lung-cancer. Accessed on: 16 Janurary 2022.

Wu Y-L, et al. Osimertinib in Resected EGFR- Mutated Non–Small-Cell Lung Cancer. N Engl J Med 2020; 383:1711-1723.

Spicer J, et al. Surgical outcomes from the phase 3 CheckMate 816 trial: Nivolumab (NIVO) + platinum- doublet chemotherapy (chemo) vs chemo alone as neoadjuvant treatment for patients with resectable non-small cell lung cancer (NSCLC). Journal of Clinical Oncology 2021 39:15_suppl, 8503-8503

Bristol Myers Squibb. Neoadjuvant Opdivo (nivolumab) Plus Chemotherapy Significantly Improves Event-Free Survival in Patients with Resectable Non-Small Cell Lung Cancer in Phase 3 CheckMate -816 Trial (11 August 2021). Available at: h t t p s : / / n e w s . b m s . c o m / n e w s / c o r p o r a t e - financial/2021/Neoadjuvant-Opdivo-nivolumab- Plus-Chemotherapy-Significantly-Improves-Event-

Free-Survival-in-Patients-with-Resectable-Non- Small-Cell-Lung-Cancer-in-Phase-3-CheckMate-- 816-Trial/default.aspx. Accessed on: 16 January 2022.

Sihoe ADL. When waters of the river and the well meet. Thorac Cancer 2021; 12: 1637-1638.

Pignon JP, et al. Lung Adjuvant Cisplatin Evaluation: A Pooled Analysis by the LACE Collaborative Group. Journal of Clinical Oncology 2008 26:21, 3552-3559.

NSCLC Meta-analysis Collaborative Group. Preoperative chemotherapy for non-small-cell lung cancer: a systematic review and meta-analysis of individual participant data. The Lancet 2014; 383: 1561 - 1571.

National Comprehensive Cancer Network. Non- Small Cell Lung Cancer (Version 8.2020). Available a t : http://www.nccn.org/professionals/physician_gls/pdf /nscl.pdf. Accessed on: November 7, 2020.

Cerfolio RJ, et al. The treatment of patients with stage IIIA non-small cell lung cancer from N2 disease: who returns to the surgical arena and who survives. Ann Thorac Surg 2008;86:912–20.

Downloads

Published

2023-07-12

How to Cite

1.
Alan D. L. Sihoe. Making a Difference in Surgery. Esculapio - JSIMS [Internet]. 2023 Jul. 12 [cited 2024 Dec. 21];17(4):317-20. Available from: https://esculapio.pk/journal/index.php/journal-files/article/view/295

Issue

Section

Guest Editorial