The Department of Thoracic Surgery at Renji Hospital, School of Medicine, Shanghai Jiaotong University, was established in the early 1950s as the Department of Thoracic and Cardiac Surgery by Liang Qichen, Wang Yishan and other renowned professors. During its initial phase, the department focused on surgical interventions for lung cancer, esophageal cancer, and thymoma. As a result of continuous development, the original department underwent further division into two distinct entities: thoracic surgery and cardiovascular surgery.
Since 2014, under the leadership of Dr. Zhao Xiaojing, the team members have collaborated effectively, resulting in a continuous expansion of both the scale and volume of thoracic surgery. Consequently, it has evolved into a specialized field with distinctive diagnostic and treatment characteristics as well as exceptional comprehensive technology. Particularly noteworthy is the stringent requirement for all doctors to enhance imaging diagnosis accuracy through meticulous management of early ground-glass opacity lesions. The preoperative diagnosis and postoperative pathological diagnosis coincidence rate for pulmonary nodules has reached an impressive 95%, positioning it at the forefront domestically. Additionally, serving as a prominent training base for thoracic surgery in Shanghai, it has successfully hosted national thoracic surgery training courses while actively contributing to the compilation of thoracic surgery chapters in textbooks used by universities nationwide.
Currently, over 3000 surgical procedures and near 700 cases of lung nodule radiation thereapy were conducted annually in the institute, by skilled surgeons with suprieum expertise, which covers various types of lobar, segmental, esophageal, and mediastinal procedures including thoracoscopic surgery, uniportal thoracoscopic surgery, and robot-assisted thoracoscopic surgery. Notably, more than 95% of lung cancer cases are treated through thoracoscopic surgery. In our approach to treating esophageal cancer, lung cancer, and mediastinal tumors, we emphasize standardized diagnostic and treatment protocols. Our achievements include a high rate of early lung cancer detection, comprehensive management of advanced lung cancer cases, and leading clinical application of thoracoscopic technology in China.
At present, the department of thoracic surgery comprises 5 chief physicians, 4associate chief physicians, 6 attending physicians, and 6 residents, among whom 14 possess doctoral degrees. Over the past five years, a total of 10 scientific research projects (including 4 funded by the National Natural Science Foundation of China) have been undertaken and more than 40 SCI papers have been published.
Clinical Programs
The utilization rate of video asisted thoracoscopic surgery exceeds 90% of the total volume of the department..The spectrum of surgical procedures includes but not limited to:
1) Lung Surgery: Standard radical resection for lung cancer, including lobectomy, pneumonectomy, pulmonary segmentectomy, pulmonary lobectomy with sleeve bronchoplasty; Lung volume reduction surgery involving bullae resection; Pleurodesis; Resection of benign pulmonary tumors; Surgical treatment for pulmonary tuberculosis and/or bronchiectasis; and Lung transplantation.
2) Tracheal Surgery: Resection of tracheal tumors, resection and plasty of the carina, and reconstruction of the second carina.
3) Esophageal Surgery: multidisciplinary team approach for local advanced or advanced esophageal cancer. Radical resection of esophageal and cardiac cancer, gastroesophageal anastomosis; Resection of esophageal cancer with colon interposition for reconstruction; Surgical management of cervical and high intrathoracic esophageal cancer, as well as reoperation for esophageal anastomotic stenosis; Heller's myotomy procedure; Resection of esophageal leiomyoma; Anti-reflux surgery for the esophagus; Repair of esophageal rupture; Diverticulectomy for the esophagus.
4) Diaphragmatic and Mediastinal Disease Surgery: Repair of traumatic diaphragmatic hernia, hiatal hernia, resection of mediastinal giant tumors, thymoma, extended thymectomy for myasthenia gravis, etc.
5) Chest Wall and Pleural Cavity Surgical Procedures: Resection of benign tumors in the chest wall; Resection of malignant tumors in the chest wall with subsequent repair and reconstruction; Correction of pectus excavatum; Dissection for empyema treatment; Decortication for chronic empyema management; Resection of pleural mesothelioma; Thoracic duct ligation; Sympathetic trunk resection for palmar hyperhidrosis.
6) Mediastinoscopy: Biopsy of mediastinal tumor and lymph nodes.
The distinctive clinical diagnosis and treatment features of our department.
1) Popularization of minimally invasive techniques
The proportion of thoracoscopic radical resection for lung cancer, esophageal cancer, and mediastinal tumors has surpassed 90% of the total operations, with a majority being uniportal thoracoscopic surgeries. Lung cancer surgeries encompass lobectomy, sleeve lobectomy, double-sleeve lobectomy, and segmentectomy. Esophagectomy includes combined thoracoscopic and laparoscopic procedures with intrathoracic (or cervical) anastomosis using gastric (or colon) replacement. Surgery for mediastinal tumors involves transthoracic or subxiphoid thoracoscopic extended resection of thymoma. In recent years, tubeless single-port thoracoscopic surgery (non-endotracheal intubation with spontaneous breathing), pneumatic mediastinoscopic esophagectomy, microwave ablation, and cryoablation for pulmonary nodules have further minimized surgical trauma.
2) Standardization of comprehensive MDT tumor treatment
Through the implementation of CT three-dimensional reconstruction, artificial intelligence-assisted diagnosis, percutaneous lung biopsy, mediastinoscopy, electromagnetic navigation bronchoscopy (ENB), ultrasonic bronchoscopy (EBUS), rapid on-site evaluation (ROSE), and other advanced technologies, the diagnostic rate of lung cancer is enhanced. This enables accurate assessment of early-stage lung cancer and facilitates the development of individualized treatment plans to prevent overtreatment. In accordance with the latest NCCN guidelines and cutting-edge research in this field, a multidisciplinary thoracic cancer MDT team has been established to ensure safe and optimized management for patients with advanced thoracic tumors such as lung cancer, esophageal cancer, thymoma, etc. Wide-ranging approaches including preoperative neoadjuvant chemotherapy, radiotherapy, targeted therapy immunotherapy as well as postoperative adjuvant therapy are extensively employed.
3) Normalization of sophisticated surgical procedures.
Various carinal (or second carinal) resections and reconstructions, double-sleeve lobectomy, lung transplantation, resection of tumors with invasion of blood vessels followed by artificial blood vessel replacement bypass, complex cervicothoracic junction tumor surgeries are routinely performed. Leveraging the strong comprehensive strength of our hospital, we also provide surgical treatment for patients with other severe chronic diseases such as uremia and rheumatic diseases. Additionally, we collaborate with other departments to perform simultaneous combined operations like lung cancer + heart valve replacement, coronary artery bypass surgery, and thoracic malignant tumor combined with other malignant tumors.