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Eur J Cardiothorac Surg 2005;27:175-176
© 2005 Elsevier Science NL

Letter to the Editor

Reply to Rocco

S. Rathinam*, P.B. Rajesh, F.J. Collins

Regional Department of Thoracic Surgery, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK

Received 17 September 2004; accepted 21 September 2004.

* Corresponding author. Tel.: +44 121 424 2562; fax: +44 121 424 0562. (E-mail: srathinam{at}rcsed.ac.uk).

Key Words: General thoracic surgery • Reconstruction • Surgical training

We thank Mr Rocco for his valuable comments regarding our article.

We agree that the thoracic surgeon should be familiar with the techniques of chest wall reconstruction and the use of muscle flaps.

These skills are very useful in malignant, benign and infective settings in cardio-thoracic surgery.

We reviewed the abstracts published in the CTSNet journals (European Journal of Cardio-thoracic Surgery, Annals of Thoracic Surgery, Journal of Thoracic and Cardiovascular Surgery and Asian Annals of Cardio-thoracic Surgery) on chest wall reconstruction to see the involvement of plastic surgeons in the published series. We found that 10 of the 18 series (55%) had plastic surgeons involved in the procedure.


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  		. Series with plastic surgical involvement
 

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  		. Series without plastic surgical involvement
 
It is important that emphasis is laid on the principles of plastic surgery and reconstruction techniques in the present setting of training changes. In the past thoracic surgeons trained first in general surgery before specializing in cardio-thoracic surgery. This gave them the skills and confidence in applying general principles in the specialty of cardio-thoracic surgery. Recent changes in training have shortened time spent in allied surgical specialties (i.e. plastic surgery, gastric and colorectal surgery).

In the current scenario of European Working Time Directive changes to thoracic surgical training, the time spent in the hospital and theatre is greatly reduced [1,2]. It is mandatory that these skills and techniques are taught to trainees by thoracic surgeons wherever possible or by arranging secondment to appropriate units to acquire these skills.

Our specialty is under intense public scrutiny in the United Kingdom, hence it is important that these skills are formally acquired and assessed with competency testing so that, thoracic surgeons can safely perform these procedures.

It is vital that these points are borne in mind while devising the thoracic surgical curricula both nationally and at the European School of Cardio thoracic Surgery.

In the West Midlands we are negotiating with the general surgical and plastic surgical training programmes to arrange appropriate training for general thoracic surgical trainees in principles of laparoscopic surgery and plastic surgery, after completion of year IV and success in the Intercollegiate Boards (UK).

References

  1. Phillip H, Fleet Z, Bowman K. The European Working Time Directive—interim report and guidance from The Royal College of Surgeons of England Working Party. London: Royal College of Surgeons; 2003.
  2. Chikwe J, de Souza AC, Pepper JR. No time to train the surgeons. Br Med J 2004;328:418-419.[Free Full Text]




This Article
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Right arrow Articles by Collins, F.J.
Related Collections
Right arrow Education
Right arrow Chest wall
Right arrow Diaphragm

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