Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Surgeons”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources
PubMed2003

Management of primary and recurrent inguinal hernia by surgeons from the South West of England.

BACKGROUND: The National Institute of Clinical Excellence (NICE) has advocated open mesh repair for primary hernia but suggested laparoscopic repair may be considered for recurrent hernias. AIM: To establish current surgical practice by surgeons from the South West of England. METHODS: A postal survey was distributed to 121 consultant surgeons and a response rate of 75% was achieved. RESULTS: The majority (86%) of the surgeons surveyed performed hernia repairs, and most (95%) of these used open mesh repair as standard for primary inguinal hernia. Only 8% used laparoscopic repair routinely for primary hernias. Few consultants (only 28%) were able to quote formally audited hernia recurrence rates. A total of 90% of respondents still employed open mesh repair routinely for recurrent hernias; however, if mesh had been used for the primary repair, this figure fell to 55%. Some 7% of respondents recommended laparoscopic repair for recurrent hernia, but this increased to 17% if the primary repair was done with mesh. All laparoscopic surgeons in the South West employed the totally extraperitoneal approach (TEP). There was a range of opinion on the technical demands of repair of a recurrent hernia previously mended with mesh; the commonest cause of mesh failure was thought to be a medial direct recurrence (insufficient mesh medially). CONCLUSIONS: Current surgical practice for primary hernias in the South West England reflects NICE guidelines although many surgeons continue to manage recurrent hernias by further open repair. In this survey, there was anecdotal evidence to suggest that hernia recurrence can be managed effectively by open repair.

Consultants↗
PubMed1998

Pediatric cardiac surgery: the effect of hospital and surgeon volume on in-hospital mortality.

OBJECTIVE: To examine the relationship between annual provider (hospital and surgeon) volume of pediatric cardiac surgery and in-hospital mortality. DESIGN: Population-based retrospective cohort study using a clinical database. SETTING: The 16 acute care hospitals in New York with certificate of need approval to perform pediatric cardiac surgery. PATIENTS: All children undergoing congenital heart surgery in New York from 1992 to 1995. MAIN OUTCOME MEASURES: Risk-adjusted mortality rates for various hospital and surgeon volume ranges. Adjustments were made for severity of illness using logistic regression. RESULTS: A total of 7169 cases were analyzed. After controlling for severity of preprocedural illness using clinical risk factors, hospitals with annual pediatric cardiac surgery volumes of fewer than 100 had significantly higher mortality rates (8.26%) than hospitals with volumes of 100 or more (5.95%), and surgeons with annual volumes of fewer than 75 had significantly higher mortality rates (8.77%) than surgeons with annual volumes of 75 or more (5.90%). CONCLUSIONS: Both hospital volume and surgeon volume are significantly associated with in-hospital mortality, and these differences persist for both high-complexity and low-complexity pediatric cardiac procedures.

Cardiac Surgical Procedures↗
PubMed1993

Exposure of the orthopaedic surgeon to radiation.

A prospective study of sixty-five orthopaedic procedures performed with fluoroscopic assistance was undertaken to determine the risk to the primary orthopaedic surgeon with regard to radiation. Radiation was monitored with the use of a universal film badge placed outside the collar of a lead apron, and a gas-sterilized thermoluminescent dosimeter ring worn on each hand. The rings were changed with every operation, but the same film badge was transferred from surgeon to surgeon. The hand dominance of the surgeon, the duration of the operative procedure, the type of operation, and the total time that fluoroscopy had been used were noted. The study was conducted during twenty-one intramedullary nailing procedures (thirteen involving distal locking), forty open reductions with internal fixation (plates and screws), and four external-fixation procedures. All of the badges and rings were submitted for a report regarding radiation exposure. No relationship was found between a ring with a positive reading for exposure to radiation and the duration of the operation. Similarly, there was no correlation between a positive reading and the surgeon's hand dominance. The mean duration of the fluoroscopy was 2.3 minutes for the group for which the rings did not show a positive reading and 4.7 minutes for the group for which the rings did show a positive reading. This was a significant difference (p < 0.0001). There was no positive reading for exposure to radiation from any ring that had been worn during a procedure in which the fluoroscope had been used for less than 1.7 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Nails↗
PubMed1998

An assessment of orthopaedic surgeons' knowledge of medical ethics.

We developed a survey instrument to evaluate knowledge of ethical issues among orthopaedic surgeons and to assess their ability to handle ethical dilemmas. The twenty-six-item survey evaluates seven areas of medical practice: confidentiality, informed consent, truth-telling, the physician-patient relationship, economic aspects of care, end-of-life decision-making, and the approach to an incompetent colleague. It was administered to 117 attending orthopaedic surgeons and residents in two orthopaedic surgery training programs. One hundred and two orthopaedic surgeons (87 per cent) completed the survey. Overall, they correctly answered a mean of nineteen (73 per cent) of the twenty-six questions. The respondents appropriately handled questions involving economic aspects, truth-telling, confidentiality, and an incompetent colleague. However, there was poorer understanding of proper ethical conduct with regard to informed consent (58 per cent of the responses were correct), the physician-patient relationship (72 per cent of the responses were correct), and end-of-life decision-making (78 per cent of the responses were correct). No significant differences were found, with the numbers available, in overall performance according to site, attending compared with resident status, age, gender, or whether the physician had had training in ethics. Economic, social, and professional forces have increased the medical ethical issues facing orthopaedic surgeons. Medical ethics now must be taught in training programs in orthopaedic surgery. Our survey of two orthopaedic surgery training programs demonstrated that orthopaedic surgeons approach most medical ethical problems appropriately. However, improvement is needed in selected areas.

Adult↗
PubMed2005

Reliability, validity, and responsiveness of the American Shoulder and Elbow Surgeons subjective shoulder scale in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis.

BACKGROUND: Outcomes assessment after the treatment of shoulder disorders has involved the use of various condition-specific outcome instruments. The purpose of this study was to determine the psychometric properties of the American Shoulder and Elbow Surgeons subjective shoulder scale in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis. METHODS: Test-retest reliability, internal consistency, content validity, criterion validity, construct validity, and responsiveness to change were determined for the American Shoulder and Elbow Surgeons shoulder scale within subsets of an overall study population of 455 patients with shoulder instability, 474 patients with rotator cuff disease, and 137 patients with glenohumeral arthritis. RESULTS: There was acceptable test-retest reliability for the overall American Shoulder and Elbow Surgeons shoulder scale (intraclass correlation coefficient = 0.94) and ten of eleven domains. There was acceptable internal consistency for patients with instability (Cronbach alpha = 0.61), rotator cuff disease (0.64), and arthritis (0.62). There were acceptable floor and ceiling effects for patients with instability (0% and 1.3%, respectively), rotator cuff disease (0% for both), and arthritis (0% for both). There was acceptable and appropriate criterion validity, with significant correlations (p < 0.05) between the overall American Shoulder and Elbow Surgeons scale and the physical functioning, role-physical, and bodily pain domains of the Short Form-12 scale, and nonsignificant correlations (p > 0.05) with the role-emotional, mental health, vitality, and social function domains. There was acceptable construct validity, with all twenty-three hypotheses demonstrating significance (p < 0.05), and acceptable responsiveness to change for patients with instability (standardized response mean, 0.93), rotator cuff disease (1.16), and arthritis (1.11). CONCLUSIONS: The use of outcome instruments with psychometric properties that have been vigorously established is essential. The American Shoulder and Elbow Surgeons subjective shoulder scale demonstrated overall acceptable psychometric performance for outcomes assessment in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis.

Adolescent↗
PubMed2005

The early effects of code 405 work rules on attitudes of orthopaedic residents and attending surgeons.

BACKGROUND: The impact of strict enforcement of Section 405 of the New York State Public Health Code to restrict resident work to eighty hours per week and the adoption of a similar policy by the Accreditation Council on Graduate Medical Education in 2002 for orthopaedic residency training have not been evaluated. Adoption of these rules has created accreditation as well as staffing problems and has generated controversy in the surgical training community. The purposes of this study were (1) to evaluate the attitudes of orthopaedic residents and attending surgeons toward the Code 405 work-hour regulations and the effect of those regulations on the perceived quality of residency training, quality of life, and patient care and (2) to quantify the effect of the work-hour restrictions on the actual number of hours worked. METHODS: We administered a thirty-four-question Likert-style questionnaire to forty-eight orthopaedic surgery residents (postgraduate years [PGY]-2 through 5) and a similar twenty-nine-question Likert-style questionnaire to thirty-nine orthopaedic attending surgeons. All questionnaires were collected anonymously and analyzed. Additionally, resident work hours before and after strict enforcement of the Code 405 regulations were obtained from resident time sheets. RESULTS: The average weekly work hours decreased from 89.25 to 74.25 hours for PGY-2 residents and from 86.5 to 73.25 hours for PGY-3 residents, and they increased from 61.5 to 68.5 hours for PGY-4 residents. Residents at all levels felt that they had increased time available for reading. There was general agreement between attending and resident surgeons that their operating experience had been negatively impacted. Senior residents thought that their education had been negatively affected, while junior residents thought that their operating experience in general had been negatively affected. Senior residents and attending surgeons felt that continuity of care had been negatively impacted. All agreed that quality of life for the residents had improved and that residents were more rested. CONCLUSIONS: On the basis of the survey data, the implementation of the new work-hour restrictions was found to result in a decrease in the number of hours worked per week for PGY-2 and PGY-3 residents and in an increase in work hours for PGY-4 residents. This could explain the definite difference between the attitudes expressed by the senior residents and those of the junior residents. Senior residents felt that their education was negatively impacted by the work rules, while junior residents expressed a more neutral view. However, senior residents did not believe that their operative experience was as negatively impacted as did junior residents. Although junior and senior residents and attending surgeons agreed that resident quality of life had improved, we were not able to determine whether this offset the perceived negative impact on education, continuity of care, and operative experience.

Attitude of Health Personnel↗
PubMed2001

George Spence: surgeon and servant of the Hudson's Bay Company, 1738-41.

At the beginning of his medical career, George Spence signed a contract with the Hudson's Bay Company (HBC) as surgeon for the Fort Albany fur trading post located on James Bay in British North America. During his first three years (1738-41), Spence encountered formidable personal and professional challenges which can be partially reconstructed through examination of surgeon's journal for 1740-41. By unique good fortune, two other corroborating journals exist for Albany from the same year: the journal of another HBC servant and the regular post journal. Spence's is the only surgeon's journal in the HBC archives prior to 1846 and one of very few such journals from any period of the company's history. This paper examines everyday medical practice in one fur trading context from the perspective of HBC employees and the recipients of medical care. George Spence's significance lies partially in the ordinary nature of his practice in contrast to heroic historical accounts, and partially in his contribution toward knowledge of an earlier context in medical history than has been previously analyzed. I have drawn on concepts from labour and professionalization history to analyze the seemingly contradictory position of the surgeon as both an autonomous professional and a servant in relation to the HBC. While Spence successfully fulfilled his role as surgeon, he struggled to meet expectations as a servant of the company. His struggle was partially based on emerging professional ideologies, and partially based on changing labour relationships within a pre-industrial society.

Canada↗
PubMed2000

Underutilization of breast-conserving therapy in a predominantly rural population: need for improved surgeon and public education.

Though breast-conserving therapy (BCT) was first recommended as the preferred treatment for women with early-stage breast cancer in 1990, little is known about the factors influencing or limiting the use of BCT in rural women. We retrospectively surveyed all surviving patients (227) referred to the Roger Maris Cancer Center over a 2-year period. Disease characteristics were verified by the tumor registry and random chart review. Responses were obtained from 171 patients (75%), a median of 26 months from diagnosis. The majority of patients were from rural areas; only 32% resided in towns with a population greater than or equal to 15,000. Thirty-five percent of those patients meeting published criteria had BCT. Patients who underwent BCT were younger (mean age 56.8 vs. 62.5, P = 0.01), more likely to have benign axillary lymph nodes (82% vs. 64%, P = 0.008), and more likely to be employed away from the home (66% vs. 44%, P = 0.01) than patients who underwent mastectomy (MRM). Distance from the nearest radiation facility did not affect treatment decisions (mean: 59.5 miles BCT vs. 52.6 miles MRM). Most patients (83%) ranked their surgeon as the most important source of information about treatment options. Perceived surgical recommendations were generally followed. Only three patients who felt their surgeon recommended MRM underwent BCT; eleven patients chose MRM though they believed their surgeon recommended BCT. The choice of local therapy is predominantly a surgeon-driven process; logistical barriers unique to a rural population had little impact. Unfortunately, many surgeons continue to apply much more stringent criteria when recommending BCT than those in published guidelines.

Adult↗
PubMed2001

How surgeon age affects post-treatment surveillance strategies for melanoma patients.

The intensity of post-treatment melanoma patient follow-up varies widely among physicians. We investigated whether physician age accounts for the observed variation in surveillance intensity among plastic surgeons. A custom-designed questionnaire was mailed to USA and non-USA surgeons, all of whom were members of the American Society of Plastic and Reconstructive Surgeons. Subjects were asked how they use 14 specific follow-up modalities during years 1-5 and 10 following primary treatment for patients with cutaneous melanoma. Repeated-measures analysis of variance was used to compare practice patterns by TNM stage, year post-surgery, and age. Of the 3,032 questionnaires mailed, 1,142 (38%) were returned. Of those returned, 395 (35%) were evaluable. Non-evaluability was usually due to lack of melanoma patient follow-up in surgeons' practices. Follow-up strategies for most of the 14 modalities were highly correlated across TNM stages and years post-surgery, as expected. The pattern of testing varied significantly by surgeon age for 3 modalities (complete blood count, liver function tests, and chest X-ray), but the variation was quite small. We concluded that the post-treatment surveillance practice patterns of ASPRS members caring for patients with cutaneous melanoma vary only marginally with physician age. Continuing medical education could account for this observation.

Adult↗
PubMedDate not supplied

Quality report cards, selection of cardiac surgeons, and racial disparities: a study of the publication of the New York State Cardiac Surgery Reports.

Quality report cards have become common in many health care markets. This study evaluates their effectiveness by examining the impact of the New York State (NYS) Cardiac Surgery Reports on selection of cardiac surgeons. The analyses compares selection of surgeons in 1991 (pre-report publication) and 1992 (post-report publication). We find that the information about a surgeon's quality published in the reports influences selection directly and diminishes the importance of surgeon experience and price as signals for quality. Furthermore, selection of surgeons for black patients is as sensitive to the published information as is the selection for white patients.

Black or African American↗
PubMedDate not supplied

Comparison of specimen adequacy in fine-needle aspiration biopsies performed by surgeons and pathologists.

BACKGROUND: Fine-needle aspiration biopsy (FNAB) may yield different results depending on its operator. We compared the proportions of unsatisfactory aspirates obtained by pathologists vs. surgeons. METHODS: In a retrospective review, all FNAB reports and slides performed between March 2002 and February 2003 were grouped by organ/site and according to whether they were done by a pathologist or a surgeon. The proportions of unsatisfactory aspirates for pathologists and surgeons were compared. RESULTS: Of 692 FNABs, 390 were performed by pathologists at the FNAC clinic and the remainder by surgeons. Overall, 15.5% of aspirates obtained were unsatisfactory (n=107). Of aspirates obtained by surgeons, 29.5% were unsatisfactory, compared to 4.6 % of those obtained by pathologists (P<0.001). Pathologists had significantly lower proportions of unsatisfactory aspirates in all sites. A 33% reduction in the number of lymph node excisional biopsies has been reported subsequent to establishment of the FNAC clinic. CONCLUSIONS: The advantages of a pathologist performing FNAB are that a rapid evaluation can be rendered regarding specimen adequacy and the need for repeating the procedure. In addition, pathologists can direct the distribution of aspirated material for other tests such as culture study, flow cytometry and electron microscopy, as indicated by preliminary evaluation of the smears. These factors significantly lower the proportions of unsatisfactory specimens and improve the diagnostic accuracy of FNAB technique.

Biopsy, Fine-Needle↗
PubMed1997

Bioabsorbable fixation devices: status for the craniomaxillofacial surgeon.

With time, more and more types of medical devices become available to assist the surgeon in managing patients. Bioabsorbable fixation devices, which have been directed toward the orthopedic surgeon over the past 10 years, are but one example. One aim of this article is to present the current status of bioabsorbable devices in medical practice to the craniomaxillofacial surgeon who may not be aware of the inroads this technology has made. A bioabsorbable fixation system has become available for use by the craniomaxillofacial surgeon, which is described. A further aim of this article is to present concisely the testing rigor required of such devices before their introduction to the U.S. market. This has the added benefit of explaining the important role of the surgeon in developing and helping reduce to standard clinical practice the use of new technologies.

Absorbable Implants↗
PubMed1999

Survey of USAF flight surgeons regarding clinical preventive services, using CHD as an indicator.

BACKGROUND: A recent Department of Defense study revealed that nonpharmacologic therapy is not well documented in medical records of individuals identified at risk for coronary heart disease (CHD). Exercise and weight control are often underemphasized relative to dietary and medication interventions, even in medical journal review articles on management of dyslipidemia. METHODS: A literature review of interventions consisting of exercise alone or with diet is presented. A brief survey was developed to assess the knowledge and beliefs of USAF flight surgeons regarding training received for, and delivery of, clinical preventive services. In addition, the respondents were given a scenario patient with high cholesterol to manage. RESULTS AND DISCUSSION: The literature review demonstrates the beneficial effect of exercise alone or with dietary interventions on reducing total cholesterol and increasing high-density lipoprotein (HDL). The survey reveals that USAF flight surgeons believe that more preventive medicine training is needed in the USAF flight surgeon course, graduate medical education, and medical school. Given a scenario patient with hypercholesterolemia, the flight surgeons believe that nonpharmacologic therapy with consults to the base Health and Wellness Center (HAWC), along with follow-up by the physician, is appropriate initial medical treatment rather than pharmacologic therapy. CONCLUSIONS: The primary treatment for prevention of CHD should be an organized exercise and diet program. This treatment is proven effective through clinical trials and is supported by the flight surgeon survey results. Additional benefits of an organized exercise and diet program include decreased obesity with its associated complications, decreased incidence of hypertension, decreased cancer risk, and decreased risk for diabetes mellitus.

Aerospace Medicine↗
PubMedDate not supplied

Surgical treatment of early breast cancer: what would surgeons choose for themselves?

CONTEXT: Although breast-conserving surgery (BCS) is less invasive than mastectomy and results in similar survival, many women eligible for BCS continue to undergo mastectomy. Whether the persistent use of mastectomy means that women do not understand their options or reflects an informed preference is unknown. OBJECTIVE: To learn which treatment surgeons would choose when asked to imagine that they themselves had early-stage breast cancer. DESIGN: Cross-sectional survey. SAMPLE: Convenience sample of 40 staff and resident surgeons attending surgical grand rounds at Dartmouth-Hitchcock Medical Center in 1998. MAIN OUTCOME MEASURE: Choice of BCS or mastectomy for the treatment of stage I breast cancer. RESULTS: Twenty-six male and 14 female surgeons participated in the survey. Half chose BCS and half chose mastectomy for treatment of their hypothetical early-stage breast cancer. Results did not differ by the sex of the surgeon. CONCLUSION: Even after being reminded of the equivalent 10-year survival statistics, half of the surgeons surveyed said that they would choose mastectomy over BCS for themselves. The assumption that BCS is the "right" choice for early-stage breast cancer may be unwarranted because many patients may have an informed preference for mastectomy.

Adult↗
PubMed2000

Is Canadian cardiac surgeons' management of asymptomatic carotid artery stenosis at coronary artery bypass supported by the literature? A survey and a critical appraisal of the literature.

OBJECTIVE: To document and compare the management of asymptomatic carotid stenosis (ACS) by Canadian cardiac surgeons at coronary artery bypass grafting (CABG) against a critical literature analysis. DESIGN: A multiple choice survey and a structured literature review. DATA SOURCES: Seventy-seven surgeons and 272 publications selected from the English literature between 1980 and 1997. Search terms used were "carotid," "coronary bypass," and "cardiac surgery." STUDY SELECTION: Five natural history studies were identified, and 58 studies were found that had objective documentation of ACS of 50% or more before cardiac surgery, and both operative stroke and mortality data reported for CABG with and without carotid endarterectomy (CEA). DATA EXTRACTION: Natural history and outcome studies were independently rated against published guidelines. Outcome data were independently pooled and compared. Data discrepancy was resolved by consensus. Survey results were tabulated for simple descriptive statistics. DATA SYNTHESIS: No methodologically sound natural history studies were found to document an increased risk of stroke from ACS after CABG. There were no randomized controlled studies to guide treatment recommendations. Pooled data for stroke or death did not support CEA for risk reduction from ACS at CABG (relative risk 0.9, p = 0.5). Ninety-four percent of surgeons believed that the literature is insufficient to support the routine use of CEA to reduce the risk of stroke from ACS after CABG. Despite this, 20% of surgeons advocated CEA for this purpose. CONCLUSION: The management of ACS at CABG by the majority of Canadian cardiac surgeons is consistent with the results of the literature review; however, significant management variation exists.

Canada↗
PubMed2000

The role of the flight surgeon in Greece.

From 1915 [corrected], the first time a flight surgeon participated in an aeromedical evacuation, to the present, the role has become more fundamental by working in wars and operations, experiencing search and rescue aeromedical evacuations from mass accidents or motor accidents, treating seriously ill individuals, and caring for wounded victims of attacks either at the scene or at the hospital. The improvements in cognitive and technological standards of medical science and in the education available have contributed in upgrading the role of flight surgeons; however, their presence in flight is considered essential in 20-60% of aeromedical evacuations, with the remainder of the flights being covered by paramedical personnel. In the Greek territory, the development of Air Force medicine began with the U.S. education of Panagiotis Korombilis, founder of the Center for Flight Crew Health Examination in 1936. In 1976, the Air Force Medical Center was established in the General Air Force Hospital while the educational and medical work of Air Force physicians led to the development of Air Force Medicine and supported Olympic Airways and Military Air Force development, which provides aircraft and personnel for patient aeromedical evacuations. An organized aeromedical evacuation system based on the National Health System, however, began operating in 1982 and was upgraded in 1994. Currently, the flight surgeon's work remains important in supporting the Military Air Force by offering regular examinations at the Air Force Medical Center for all personnel flying on civil and military aircrafts, and by educating all the Greek territory and Cypriot Air Force surgeons (of the National Emergency Assistance Center and the Military Services) at the Air Force Medical Center. Their presence at Air Force bases is important, as is their support of the overall well-being of flight personnel, their assistance in upholding the territory's future by improving aircraft and equipment and by purchasing search-rescue aeromedical evacuation helicopters and hospital aeromedical transportation aircraft capable of transporting seriously ill patients, their promotion of collaboration with other countries in educating Air Force surgeons, and in support of valuable human life according to the Hippocratic Oath.

Aerospace Medicine↗
PubMed1975

Time utilization of a population of general surgeons in community practice.

A time-motion study was performed on a population of general surgeons in suburban community practice whose median weekly operative work load had been previously determined to be 3.1 hernia equivalents (HE). The mean observed 6 day working week of this population of general surgeons was found to be 34.5 hours, of which 28.7 hours were devoted to professional activities for the total work week of 44.3 hours. Thirty-five percent of the mean observed working week was spent in office activities and 50 percent spent in hospital activities. During the mean observed week, 18.5 hours (54 percent) were devoted to patient care, of which 16.5 hours were judged to be devoted to surgical care. Surgeons with above-median operative work loads in the previous study devoted 67 percent more time to professional activities and twice as much time to surgical activities as surgeons with below-median work loads. The findings support the hypothesis that there appears to be an underutilization of costly and highly specialized medical skills in the particular community and suggest that the HE methodology is a valid measure not only of the operative work of surgeons in community practice but of total time devoted to surgical care.

Delivery of Health Care↗
PubMed2002

[One hundred years of the Association of Surgeons in the Netherlands. IV. Thoracic surgery].

In the Netherlands, two disciplines are involved, in thoracic surgery. Firstly, general surgeons, since thoracic surgery initially consisted of surgical treatment for pulmonary tuberculosis, bronchiectasis and empyema. Once tuberculostatics became available, surgical treatment of pulmonary tuberculosis became less important and lung/thoracic operations were carried out primarily for lung cancer. Secondly, cardio-pulmonary surgeons (now known as 'cardiothoracic surgeons') also play a role in thoracic surgery. This discipline is also allowed to carry out heart surgery. Surgery for stage-I and -II lung cancer is the mainstay of the practice of general thoracic surgeons. Surgery after induction chemotherapy for stage-III tumours is under investigation to find out whether this will improve treatment results. Video-assisted thoracic surgery (VATS) is a most interesting development, and has led to the revival of volume-reduction surgery for lung emphysema. Education is of paramount importance in ensuring the quality of surgery. In the near future there will be a need for qualified thoracic surgeons in the Netherlands and organisational and financial measures should be taken to prevent a shortage.

History, 20th Century↗