Kenneth Williams and the Future of Surgery

In the 1940s,  general surgeons operated on most body cavities, including the thoracic cavity. During the 1960s, the speciality of cardiothoracic surgery emerged - surgeons operating on 'just' the lungs, the heart and the oesophagus.

HEALTH BENEFITS OF THORACIC SURGEONS

This audit demonstrates to me the benefit of the decision, around 10 years ago to split thoracic surgery training from that of cardiac surgery. A number of excellent trainees during that time went on to become consultants and significantly increased the resection rate of lung cancers thus undoubtedly improving the survival chances of these patients. It also suggests that thoracic and not cardiothoracic surgeons are best suited to surgically treat this horrible disease. With modernization (3rd or 4th attempt in the modern era!) of UK postgraduate medical training, that decision to have 2 separate streams of training (for cardiac and thoracic) was reversed . This audit confirms the folly of that decision.

EVIDENCE

JAMA -- Mediastinoscopy vs Endosonography for Mediastinal Nodal Staging of Lung Cancer: A Randomized Trial, November 24, 2010, Annema et al. 304 (20): 2245

I used to practice both cardiac and thoracic surgery until August 2007. After the appointment of 2 purely thoracic surgeons to our department, 2 of us who practiced both disciplines had to give up thoracic surgery. For various reasons that I won't go into now, I decided to give up thoracic surgery and stick to cardiac. Although this paper will not affect my practice, it still gives me great pleasure to see a well conducted surgical trial that produces good evidence that surgeons can use in their everyday practice - even though the results of the study means less surgery. We need more of these.