Thoracic surgery in Egypt

Our plain-English summary of Thoracic surgery in Egypt, by H. Elkhayat, H.H. Elsayed, W. Adel, et al (Journal of Thoracic Disease, 2022).

The study

• Authors: H. Elkhayat, H.H. Elsayed, W. Adel, A.G. Elkhouly, A. Abdellateef, W.A.M. Amin, A.I. Abd El Hafiez, H. Beshir, Y.A. Elsayed, M.M. Elhamami, E.A.M. Wahby, E.E. Gamil, A. Elminshawy
• Journal: Journal of Thoracic Disease
• Published: 2022;14(4):1282-1295
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

General thoracic surgery operations in Egypt are performed mainly by cardiothoracic surgeons and less oftenly by dedicated thoracic surgeons and general surgeons. This is mainly due to the relatively small number of thoracic surgeons in relation to population as only 210 cardiothoracic surgery specialists and 458 consultants are registered with the Egyptian Medical Syndicate (EMS) in a country with a population of more than 100 million people. Thoracic surgeons in Egypt are faced with a number of burdens, including the need to propagate the service to advanced technology infront of the obstacle of limited resources. Other burdens include higher incidence of TB, trauma and foreign body inhalation related to cultural backgrounds. More centres now are major video-assisted thoracic surgery (VATS) providing centres and others are specialized in more complex surgeries like complicated airway procedures and radical surgery for mesothelioma. As part of the international community, the COVID-19 pandemic has put more burdens on the thoracic surgery service as most centres have reduced their elective surgery workload to less than half of usual. Interestingly, the pandemic has allowed a self-referral screening programme with widespread Computed Tomography (CT) chest being performed among the population allowing thoracic surgeons to operate more on early stage lung cancer. The academic challenges for thoracic surgeons are even more with need for developing national databases. Nevertheless, thoracic surgeons in Egypt are optimistic regarding the future. The rising interest among the younger population will push training programs to meet the interests of enthusiastic junior surgeons. While the ancient history of thoracic surgery in Egypt seems to be extraordinary, the future perspectives promise to be more rewarding.

2022 Journal of Thoracic Disease. All rights reserved.

In plain English

This article was a review, commissioned for a journal series on thoracic surgery around the world. It described the history, training, workload and challenges of chest surgery in Egypt and was not a study of asbestos exposure. As part of it, the authors collected clinical audit data from 9 major thoracic surgery centers. Over the last 3 years these centers performed a mean of 1,533 cases per year, or a mean of 170.3 per center (range 100 to 330). Decortication, done either open or by video-assisted thoracic surgery (VATS), was the most common operation, followed by lobectomy and thymectomy in most centers. VATS made up 30.5% of cases per institution (range 17.8% to 51.2%). The authors reported that mesothelioma surgery was among the most common operations in two centers, which they described as likely very close to industrial areas where asbestos is still in use. They did not name fiber types, give mesothelioma case numbers, or say whether the disease was pleural or peritoneal. The authors concluded that thoracic surgeons in Egypt are optimistic about the future of their specialty.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review article on thoracic surgery in Egypt, including a clinical audit of major centers
• Who was studied: Thoracic surgery services and surgeons in Egypt, with audit data from 9 major thoracic surgery centers (a major center was defined as more than 100 major cases per year) over the last 3 years
• Exposure: No exposure was studied. Asbestos was mentioned only in passing, as the likely reason mesothelioma surgery was common in two centers. No fiber type was named.
• Main results:
  • Across the 9 audited major centers, a mean of 1,533 cases per year were performed during the last 3 years, with a mean of 170.3 per center (range 100 to 330)
  • In the audited centers, the most common operation was decortication (open or VATS), followed by lobectomy and thymectomy in most centers
  • Mesothelioma surgery was among the most common operations in two centers. The authors described these centers as likely very close to industrial areas where asbestos is still in use. No case numbers were given.
  • VATS cases made up 30.5% of total cases per institution, ranging from 17.8% to 51.2%
  • In 7 major thoracic centers, a mean of 1,428 bronchoscopies were carried out per year, with a mean of 204 per center (range 71 to 324)
  • Registered with the Egyptian Medical Syndicate were 210 cardiothoracic surgery specialists, 355 A-level consultants, 10 B-level consultants and 93 C-level consultants, for a population of more than 100 million
• The authors' conclusion: The authors concluded that thoracic surgeons in Egypt are optimistic about the future of their specialty
• Limitations the authors state:
  • The number of private thoracic surgery units was not estimated
  • The authors noted a need for a national database for registry and research

Topics

Medical terms in this study, explained in our Lexicon: Thoracic Surgery, Video-Assisted Thoracoscopic Surgery (VATS), Mesothelioma, Lung Cancer.

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