Cardiothoracic Surgery

| General Overview |--------------

Clinical work in the Department of Cardiothoracic Surgery of Huashan Hospital began in the 1980s. Under the unremitting efforts and promotion of renowned experts of the older generation such as Huang Jiasi, Shi Meixin and Mao Lüyan, the department became independent in the 1990s, with Professor Mao Lüyan as its first director. After the work of the two successive directors Professor Yao Yaqi and Professor Chen Zhiming, relying on the advantageous resources of Huashan Hospital, the department carried out a great deal of fruitful diagnosis and treatment for cardiothoracic diseases such as lung cancer, esophageal cancer, heart valve disease, coronary heart disease, mediastinal tumors and myasthenia gravis, and safely and effectively performed a series of highly difficult operations, relieving suffering for countless patients and producing good social effects. Since 2013, when the renowned thoracic surgery expert Professor Chen Xiaofeng joined the Department of Cardiothoracic Surgery of Huashan Hospital from the Pulmonary Hospital and became director, the scale and industry influence of our cardiothoracic surgery have been further promoted and expanded. The Department of Cardiothoracic Surgery of Huashan Hospital has become a cardiothoracic surgery center with 112 beds and an annual surgical volume of about 5,000, covering three campuses: the main hospital, the Baoshan Campus (North Hospital) and the Hongqiao Campus (West Hospital). It is currently led by Professor Pang Liewen.

The Department of Cardiothoracic Surgery of Huashan Hospital routinely performs the following operations, all with good therapeutic results: 1. Lung cancer surgery (including minimally invasive and traditional radical resection for lung cancer): lobectomy, bronchoplastic sleeve lobectomy, superior vena cava resection with artificial blood vessel replacement, double sleeve resection of the pulmonary artery and bronchus, precise segmentectomy; 2. Esophageal surgery: radical resection of esophageal and cardiac (gastroesophageal junction) cancer, colonic and jejunal replacement of the esophagus; 3. Tracheal surgery: carina resection and reconstruction, tracheal tumor resection; 4. Resection of benign and malignant tumors of the mediastinum, diaphragm, chest wall and pleura, and repair of diaphragmatic hernia and hiatal hernia; 5. Minimally invasive thoracoscopic or mediastinoscopic surgery for various benign lung diseases; 6. Correction of adult congenital heart disease, great vessel surgery; 7. Cardiac valve plasty or replacement; 8. Off-pump coronary artery bypass grafting.

Individuals or the group of the department have won the Ministry of Education Science and Technology Achievement Award in 2001, the Shanghai Science and Technology Progress Second Prize in 2001, the Shanghai Clinical Medical Achievement Second Prize in 2003, the Shanghai Science and Technology Achievement Award in 2006, the Shanghai Science and Technology Achievement Award in 2009, the Shanghai Medical Achievement Second Prize in 2012, and the Jiangsu Province Introduction of New Technologies and New Projects Second Prize in 2012.

| Department Features |--------------

After decades of development and the hard work and innovation of several generations of Huashan people, the department has gradually formed the following features in the diagnosis and treatment of clinical diseases:

I. Wide application of minimally invasive surgery

The Department of Cardiothoracic Surgery of Huashan Hospital was one of the earliest units in China to carry out thoracoscopic minimally invasive surgery, and its level of minimally invasive surgical application is at the leading position in the country. Currently thoracoscopic surgery accounts for more than 95% of total operations. It can routinely perform complex operations such as thoracoscopic radical resection of lung cancer, radical resection of esophageal cancer, resection of mediastinal tumors, resection of pulmonary bullae in pneumothorax, sympathectomy for palmar hyperhidrosis, and NUSS procedure for pectus excavatum. Under the leadership and promotion of Professor Chen Xiaofeng, highly difficult operations such as uniportal thoracoscopic radical resection of lung cancer, segmentectomy, and thoracoscopic double-sleeve resection of pulmonary artery and bronchus for lung cancer with a single operative port have received high recognition in the profession and wide praise from patients.

II. High degree of standardization in tumor diagnosis and treatment

With the increasing incidence of lung cancer and other malignant tumors year by year, the Department of Cardiothoracic Surgery of Huashan Hospital is committed to standardized diagnosis and treatment of tumors, including standardization of multidisciplinary comprehensive treatment, standardization of surgical operation, and standardization of postoperative adjuvant chemotherapy and follow-up.

Standardization of multidisciplinary comprehensive treatment: in collaboration with the Department of Respiratory Medicine, Oncology, Radiology, Nuclear Medicine, Radiotherapy and Pathology, a comprehensive assessment of the patient's basic condition and surgical indications is made. With reference to international and domestic tumor diagnosis and treatment guidelines, individualized treatment plans are formulated under the premise of standardization.

Standardization of surgical operation: including standardization of the extent of surgical resection and of lymph node dissection; during surgery, special attention is paid to dissection of mediastinal lymph nodes in lung cancer, upper mediastinal pararecurrent laryngeal nerve and cervical lymph nodes in esophageal cancer, and mediastinal and abdominal lymph nodes in cardiac cancer. Intraoperative rapid pathological examination of resection margins is performed to ensure thorough surgical resection and accurate postoperative pathological staging, minimizing short- and long-term tumor recurrence and prolonging patient survival.

Standardization of follow-up: follow-up is conducted according to established operating procedures, and a complete patient database is established to minimize iatrogenic loss to follow-up, ensuring that follow-up data are credible and usable and better serving subsequent clinical treatment.

III. Myasthenia gravis and mediastinal surgery

The Department of Cardiothoracic Surgery of Huashan Hospital has accumulated rich experience in the surgical treatment of myasthenia gravis. The number of operations and surgical outcomes are at the national leading level, and related achievements have won the Shanghai Science and Technology Achievement Award. In recent years, the department has innovatively carried out thoracoscopic resection of anterior mediastinal fat and thymus (tumor), further reducing surgical trauma and receiving wide praise from patients and their families. Close cooperation with the Department of Neurology has greatly improved the prognosis of patients with myasthenia gravis. In cooperation with Hand Surgery, the department has further reduced injuries to the brachial plexus and subclavian vessels in operations on apical chest tumors and Pancoast tumors, improving the radicality of tumor treatment and at the same time improving patients' quality of life. Cooperation with Neurosurgery has made one-stage radical resection of posterior mediastinal and intraspinal dumbbell-shaped neurogenic tumors a routine procedure.

IV. Refined cardiac surgery

The Department of Cardiothoracic Surgery of Huashan Hospital was one of the earliest units in China to carry out cardiac surgery. In 1990 Professor Mao Lüyan began at Huashan Hospital to perform repair of atrial and ventricular septal defects under extracorporeal circulation, correction of tetralogy of Fallot, and mitral and aortic valve replacement. At the end of 1992, Professor Liu Xiaocheng performed coronary artery bypass surgery at the Department of Cardiothoracic Surgery of Huashan Hospital. Famous experts such as Shi Meixin, Wang Minsheng, Wang Chunsheng, Zhao Qiang, Mei Ju and Chen Zhanggen all came to the Department of Cardiothoracic Surgery of Huashan Hospital to provide guidance. At the end of 2002, Professor Stanley's team from Massachusetts General Hospital cooperated with the department for two weeks, performing more than ten cardiac operations.

In 2007, Professor Wang Yiqing took charge of the cardiac surgery work, and cardiac surgery activities began to become routine and large-scale. The proportion of off-pump coronary artery bypass grafting is at the national leading level, achieving a high cure rate while ensuring good surgical safety, and small-incision bypass and hybrid procedures have been successfully carried out. In recent years, the department has actively promoted comprehensive minimally invasive cardiac surgery, including thoracoscopic minimally invasive mitral plasty/replacement, minimally invasive aortic valve surgery, total thoracoscopic repair of atrial septal defect/ventricular septal defect, total thoracoscopic surgical ablation of atrial fibrillation and left atrial appendage resection, etc., achieving the same therapeutic results as traditional open surgery while significantly reducing incisions, shortening hospitalization and achieving cosmetic effects. The application of interventional aortic valve surgery (TAVI) and interventional mitral valve clipping has significantly reduced the surgical risk for high-risk patients. In addition, the department routinely performs highly difficult great vessel operations such as aortic aneurysm surgery and total arch replacement for aortic dissection, with surgical safety at the national leading level. The department also carries out special operations such as combined cardiac and lung cancer surgery, combined cardiac and gastrointestinal surgery, and coronary artery bypass grafting combined with carotid endarterectomy, and its level of combined surgery ranks among the top in the country. The department is committed to improving surgical success rates, reducing perioperative mortality and complication rates, and safeguarding patients' long-term quality of life.

The cardiac team has long studied clinical treatment strategies for ischemic mitral regurgitation and established a novel scale scoring system to assist in formulating surgical plans, which has been widely recognized by peers at home and abroad, and the team participated in the formulation of international guidelines for this disease. Its achievements have been published many times in JTCVS, ATS, EJCTS and other top three international cardiothoracic surgery journals, and the team has given special reports many times at the highest-level professional conferences such as the American Association for Thoracic Surgery (AATS), the European Association for Cardio-Thoracic Surgery (EACTS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS) and the Chinese Society of Thoracic and Cardiovascular Surgery, winning the Excellent Paper Award of the Asian Society for Cardiovascular and Thoracic Surgery. At the same time, the department attaches importance to cardio-cerebral interaction research and has obtained many important national and provincial-ministerial projects such as the National Natural Science Foundation, the Shanghai Science and Technology Commission Fund and the Shenkang Clinical Cultivation Program. The off-pump coronary artery bypass technique has won important awards such as the Shanghai Science and Technology Progress Second Prize and the Ministry of Education Science and Technology Achievement. At present, the Huashan cardiac surgery team has 3 members with senior professional titles, 1 doctoral supervisor and 2 master's supervisors; it has trained many outstanding doctoral and master's graduates, cultivating fresh backbone forces; the team structure is reasonable and full of vigor.

| Expert Team |--------------

The Department of Cardiothoracic Surgery of Huashan Hospital is a doctoral degree conferral point of Fudan University, with currently 2 doctoral supervisors and 3 master's supervisors. It has trained many doctoral and master's students for many consecutive years. So far, physicians in the department have published more than one hundred papers in domestic core journals and SCI-indexed journals, and have edited or co-edited 7 professional monographs. They have obtained 6 National Natural Science Foundation projects, 1 key Shanghai-funded project and 7 provincial and municipal fund projects. The department currently has 30 physicians in total, including 12 with senior titles. Clinics are held regularly from Monday to Saturday. With the work conviction of unity, dedication, enterprising spirit and courage to surpass, all the medical and nursing staff of the department wholeheartedly serve the patients, striving to achieve comprehensive success in clinical work, scientific research and teaching and to forge new brilliance.