General thoracic surgery as a subspecialty in Colombia

Abstract

BRIEF HISTORY OF GENERAL THORACIC SURGERY Chest surgery has come a long way from a single costal extraction to populate the earth to a procedure that resembles a video game. Thoracic surgery has been known since ancient times, however it was not until the past century that general thoracic surgery has become a separate surgical subspecialty. As this field of surgery has evolved, so has our knowledge of diseases we treat inside the chest. 1 At the beginning of the 20th century, the field of general surgery began expanding in response to the need for expertise in different areas of surgery. During the first half of the 20th century tuberculosis was the pathology most significant to the general thoracic surgeon. With this epidemic, along with World War I-related chest injuries, a special need for surgeons knowledgeable in thoracic diseases arose. Because of this need, general surgeons would begin dedicating their practice to thoracic pathologies. 2,3 In 1909 Jacobaeus performed his famous thoracoscopy, this first important period in thoracic surgery was known as the era of enthusiasm. By 1914 tuberculosis was a worldwide pandemic and for some time it became the number one cause of death in Colombia. War and tuberculosis were the 2 main factors pivoting general thoracic from general surgery, although it was not foreign war but domestic armed conflict that required the Colombian general surgeon to start focusing on chest injuries. In 1914, Dr Pompilio Mart ınez performed the country's first cardiac suture because of a penetrating chest injury in Bogota. To answer to this new era of thoracic warfare injuries and tuberculosis, the American Association for Thoracic Surgery was created in 1917. 4-6 It is worth mentioning that the first surgery ever filmed was a general thoracic procedure by Dr Alejandro Posada in 1899 in Argentina. Because cardiovascular disease was not a major issue at this time, the need for 2 separate thoracic subspecialties was not necessary, and thus North America and Europe

Facing the challenges of perioperative air leaks using water seal in Colombia

“…In 2012, robotic thoracic surgery was introduced, however, its growth has been slow. 1 Patients generally undergo surgery when bronchoscopic treatment fails, or when there is a prolonged air leak with a collapsed lung.…”

“…With a scarcity of state-of-the-art technology, thoracic surgeons must not only adapt to the resources available, but also balance treatment using limited contemporary technology. 1 Consequently, whether elective or emergency cases, postoperative air leaks result in prolonged hospital stay, complications, and increased hospital costs. 2,3 Although treatment options have improved the way air leaks are managed, early detection and intervention still remain a clinical challenge.…”

“…In Colombia, armed conflict continues to be a significant cause of trauma, as well as an important socioeconomic and health problem. 1 The history of cardiothoracic trauma goes back centuries, and the first reported surgical intervention for a penetrating cardiac injury was in 1914. 1 Since then, the way thoracic trauma is approached in Colombia has advanced significantly, including post-traumatic air-leak management.…”

“…1 The history of cardiothoracic trauma goes back centuries, and the first reported surgical intervention for a penetrating cardiac injury was in 1914. 1 Since then, the way thoracic trauma is approached in Colombia has advanced significantly, including post-traumatic air-leak management. Compared to other Latin American countries, Colombia continues to have one of the highest penetrating thoracic injury rates, as well as incidences of gun-shot wounds.…”

Minimally Invasive Cardiac Surgery in Colombia: Evolution and the Impact of International Training

“…Cardiac surgery in Colombia evolved alongside North America and Europe in many aspects concerning technological advancements to improve patient care. [1][2][3] Considering the developing nature of Colombia, cardiothoracic surgery lagged behind for some years until a wave of younger surgeons looked to adopt the minimally invasive horizons in cardiovascular surgery. In this paper we present Colombia's evolution with regard to minimally invasive cardiovascular surgical (MICS) approaches and visions for the future.…”