International ward round: a 10-day academic visit of Professor Eugenio Pompeo in China

On the early morning of July 17, 2015 in Xiaoshan international airport in Hangzhou, I was delighted to meet Professor Eugenio Pompeo from Tor Vergata University of Rome in Italy. With great honor, in the next 10 days I had a chance to witness the significant academic and clinical communications between Professor Eugenio Pompeo and Chinese doctors and scholars, as well as the interesting stories behind by accompanying Professor Eugenio Pompeo throughout his whole trip in China (Figure 1).

Figure 1 The course of Professor Eugenio Pompeo’s visit to the four hospitals in China in July 2015.

This was the second time for Professor Eugenio Pompeo to visit China. Compared with the visit in last year, Professor Pompeo praised the rapid development of thoracic surgery in China, and said he was surprised to see the incredibly huge numbers of thoracic beds and thoracic procedures performed every day in the Chinese hospitals. Professor Pompeo also spoke highly of the Chinese young surgeons who were well trained in the Chinese hospitals. Now let’s take a close look at what has happened during the 10-day trip in China.

First stop: Zhejiang Cancer Hospital, Hangzhou

It was our first stop to arrive in Zhejiang Cancer Hospital. At about 8:00 a.m. of July 20 when we arrived, the hospital was filled with people and the crow has extended to the road out of the hospital. We were glad to meet Professor Qixun Chen, Director of Thoracic Surgery Department in the Zhejiang Cancer Hospital. During his ward round (Figure 2), Professor Chen asked patients about their feedback with the treatments, meanwhile introduced the cases to Professor Pompeo. Obviously, this was a good chance for the two doctors of different countries to exchange their experience of managing tough thoracic cases, and to seek differences and similarities between Chinese and Italian patients.

Figure 2 Professor Eugenio Pompeo and Professor Qixun Chen were discussing tough thoracic cases on the ward round.

After the ward round, we prepared to visit the operation room. Starting with a piece of peaceful light music, Dr. Jinshi Liu and his team began the uniportal VATS lobectomy, which took only 1 h (Figure 3). While performing the lobectomy, Dr. Liu introduced tough situations confronted in the procedure. Seeing the black lymph nodes, Dr. Liu popped out with a jestful question, “What is the color of lymph nodes of European patients, white or black?” Professor Pompeo joked back with a laugh, “It is white. So lymph nodes of Chinese patients are easier to identify.” But seriously impressed by this quick procedure, Professor Pompeo showed his intense interest to try the extensive lymph node clearance after he comes back to Italy.

Figure 3 Professor Eugenio Pompeo was watching the uniportal VATS lobectomy performed by Dr. Jinshi Liu.

Next, we watched a “three-port thoracoscopic radical esophagectomy for esophageal cancer” performed by Professor Qixun Chen (Figure 4). As there are rare chances to perform esophageal surgery in Italy because there are very few esophageal patients, Professor Pompeo was excited to watch this esophageal surgery. Though this difficult procedure lasted for about 5 hours, it was a beautiful one as commented by Professor Pompeo.

Figure 4 (A) Professor Eugenio Pompeo was watching “three-port thoracoscopic radical esophagectomy for esophagus cancer” performed by Professor Qixun Chen; (B) Professor Eugenio Pompeo and Professor Qixun Chen were discussing more surgical details after the operation.

After showing Professor Eugenio Pompeo around the Zhejiang Cancer Hospital, Professor Qixun Chen summarized, “I think the communication with Professor Pompeo is simple but efficient, and will promote the understanding of thoracic surgery between China and Italy” (Figure 5).

Figure 5 The photo of Professor Eugenio Pompeo (right) and Professor Qixun Chen (left) in Zhejiang Cancer Hospital.

Second stop: Shanghai Chest Hospital, Shanghai

On the rainy morning of July 23, Professor Pompeo’s visit to Shanghai Chest Hospital started with his lecture “Minimally Invasive Thoracic Surgery: New trends in Italy”. Professor Pompeo introduced the development of uniportal VATS, non-intubated VATS, robotic VATS, and VATS lobectomy in Italy, which provided a panorama of the minimally invasive surgery in Italy to the Chinese counterparts (Figure 6). After listening to this lecture, a number of Chinese thoracic surgeons on site raised their questions to discuss with Professor Pompeo, particularly on the technique of non-intubated non-resectional lung volume reduction surgery. Later Professor Wentao Fang, Deputy Director of Thoracic Surgery Department of Shanghai Chest Hospital, said “I was impressed to see that, 23 hospitals in Europe have accumulated more than 1,600 cases of single-port VATS in a short time, and obtained valuable research outcomes in ergonomic evaluation. Although the quantity of Italian patients is not as large as that of China, the European team has done a good job in multi-center clinical research, which catches the frontiers in the development of thoracic surgical techniques. A responsible attitude in accordance with the medical ethics toward a new technology which has been fully embodied by Professor Pompeo’s introduction and views on the development of minimally invasive thoracic surgery in Italy, is admirable and worth our learning. It is true that despite we have great enthusiasm to embrace a new technology; we should keep a scientific and prudent attitude.” (Figure 7).

Figure 6 Professor Eugenio Pompeo was giving his lecture on “Minimally Invasive Thoracic Surgery: New trends in Italy” in Shanghai Chest Hospital.

Figure 7 Professor Eugenio Pompeo (left) and Professor Wentao Fang (right) in Shanghai Chest Hospital.

Then Professor Haiquan Chen, President of the Shanghai Chest Hospital and Director of Thoracic Surgery Department showed us around the thoracic surgery department. As introduced, there would be 60 operations to be performed on that day. We watched six operations within 4 h, which included the right lower lobe lobectomy and lung segmentectomy performed by Professor Haiquan Chen, the robotic lobectomy by Professor Qingquan Luo, as well the lobectomy by Professor Wentao Fang (Figure 8).

Figure 8 (A) Professor Haiquan Chen was performing the right lower lobe lobectomy; (B) Professor Haiquan Chen (left), Professor Eugenio Pompeo (middle), Professor Qingquan Luo (right) in the operating room.

After watching different kinds of procedures, Professor Pompeo recalled that he was impressed by the quick and mature thoracic skills and ingenious ways to deal with intraoperative complications by these experienced Chinese thoracic surgeons.

Third stop: Tangdu Hospital, Xi’an

On July 25, we were well received by Dr. Jinbo Zhao from the Thoracic Surgery Department of Dangdu Hospital in Xi’an, Shaanxi, China. As Dr. Zhao introduced (Figure 9), there were totally 393 beds in their Thoracic Surgery Department. In 2014, more than 4,500 thoracic operations were performed in their department. Professor Pompeo exclaimed, “This is one of the largest thoracic surgery departments I had ever seen, for the beds’ number is even much larger than the sum of the thoracic surgery departments combined in Rome.”

Figure 9 Professor Pompeo and Dr. Jinbo Zhao were in deep discussion.

Next, we were honored to meet Professor Xiaofei Li in his office. Professor Xiaofei Li is Director of Thoracic Surgery Department in Tangdu Hospital. During this short visit, Professor Pompeo and Professor Li had an interesting and profound exchange on various surgical techniques. Professor Pompeo introduced “non-resection of lung volume reduction surgery under local anesthesia”, while Professor Li displayed his original “double patch” approach to repair the tracheoesophageal fistula (Figure 10). Afterwards, Professor Pompeo said, “The hospital has performed the most complicated procedure. The surgical technique they showed is a very successful one and they developed it by their own. It is original.”

Figure 10 Professor Xiaofei Li was introducing the information of the patient who has been performed “double patch” approach to repair the tracheoesophageal fistula.

As a young surgeon, Dr. Jinbo Zhao was enlightened by the talk with Professor Pompeo as well. He commented, “My strongest inspiration is about ‘innovation’! Both the surgical technique of non-resectional lung volume reduction surgery under local anesthesia introduced by Professor Pompeo, and our skill of double-patch approach to repair the tracheoesophageal fistula, are results of innovation. It is innovation that pushes the thoracic surgery forward and produces more substantial communication and cooperation.” (Figure 11).

Figure 11 The group photo in Tangdu Hospital (from left to right): AME Science Editor Chao-Xiu (Melanie) He, Dr. Jinbo Zhao, Professor Eugenio Pompeo, Professor Xiaofei Li, Professor Li’s secretaire.

Fourth and final stop: The First Affiliated Hospital of Guangzhou Medical University, Guangzhou

This is the second time for Professor Pompeo to visit the First Affiliated Hospital of Guangzhou Medical University. However, the new techniques of 3D-VATS and glass-free 3D VATS shown by Professor Jianxing He and his team have brought a bran-new experience to Professor Pompeo (Figure 12).

Figure 12 Professor Eugenio Pompeo was watching the Glass-free 3D VATS performed by Professor Jianxing He, who is the President of the First Affiliated Hospital of Guangzhou Medical University and Director of its Thoracic Surgery Department.

As both Professor Pompeo and Professor He are the pioneers who perform the largest number of non-intubated thoracic surgery in Italy and China respectively, they have had a fruitful discussion upon the forthcoming cooperative projects in the clinical research of non-intubated thoracic surgery (Figure 13).

Figure 13 Further discussions between Professor Jianxing He and Professor Eugenio Pompeo.

Summary

Looking back to the 10 days’ special trip, Professor Pompeo summarized satisfactorily, “This is a fulfilled trip, during which I have not only seen the beautiful sceneries, but also have further known about the thoracic surgery in China. I look forward to the upcoming cooperation between China and Europe in the field of thoracic surgery.”

As a companion, I was lucky to experience the unforgettable trip with Professor Pompeo within the ten days, which has enhanced communications and created valuable cooperation between Italy and China in thoracic surgery. This is the reason why I would like to write down this manuscript. Hopefully, beginning with the successful communication this time, we are going to create more chances to promote the communication and cooperation between China and Europe, even and the other part of the world.

Acknowledgements

None.

Footnote

Conflicts of Interest: The author has no conflicts of interest to declare.