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Y.T. Kim
Moderator of
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SC30 - Novel Approaches and Regulation in Surgical Education (ID 354)
- Event: WCLC 2016
- Type: Science Session
- Track: Surgery
- Presentations: 4
- Moderators:D. Grunenwald, Y.T. Kim
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall C8
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SC30.01 - Robotic Surgery: The Future in Thoracic Surgery? (ID 6726)
14:30 - 14:50 | Author(s): H. Cheufou
- Abstract
- Presentation
Abstract not provided
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SC30.02 - Animal Models for Training of Thoracic Surgeons (ID 6727)
14:50 - 15:10 | Author(s): Y.T. Kim
- Abstract
- Presentation
Abstract not provided
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SC30.03 - E-Learning in Thoracic Oncology (ID 6728)
15:10 - 15:30 | Author(s): J. Assouad
- Abstract
- Presentation
Abstract:
Advances in modern technologies allows for an increasing opportunities in surgical and medical education. The main advantages for e-learning process are: accessibility and flexibility. A range of platforms offers educational programs accessible at work or home with total temporal and spatial freedom. Trainees are allowed to access their learning environment at a convenient time and relevant to their own training needs. Several techniques are available: web-based data, interactive online modules, and virtual reality. This is especially true within surgical training where the development of new techniques constantly evolves. The rapid and constant evolution in oncology knowledge’s makes it relevant for e-leaning process. E learning allows trainees to apply and be assessed on the new information in a safe setting. In addition, all contents can be discussed and debated around the medical world without any limits. The level of trainees recall can be significantly increased by e-learning techniques because it stimulates multi-sensory experiences. E learning offers also large possibilities for decision making based on available information and interactive decision-making process. Surgical e-learning programs include the development of knowledge, technical skills, non-technical skills and decision-making process. The content of all the e-learning modules should be relevant; best available, up to date and critically appraised evidence should supports the information contained within the modules. E-learning surgical programs should be based on an understanding of educational principles, peer review resources associated to creativity. It could be highly interactive. Immersive questions and answers for clinical setting permit to trainee to progress through scenarios and makes the relevant decisions and choices. Trainees have to evolve with their decisions and receive feedback as to the choices they have made. These interactive models can be created with text on the page or with simulators. E-learning modules should be used as a complementary tool to traditional learning methods. Authors will present their e-learning thoracic platform created at September 2013 : “Tenon Thoracic Institute“ (www.tenon-thoracic-institute).This e-leaning thoracic platform develops several e-learning tools: live from OR with interactive discussion with faculty, round table with exerts, didactic session for young trainees. All the aspects around thoracic pathology are treated: oncology, surgery, anaesthesiology, radiology, etc. Authors will discuss the relevance of such a platform, the lack of its content and future e-leaning projects.
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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SC30.04 - Impact of Working Time Directives on Thoracic Surgical Training: The North-American Experience (ID 6730)
15:30 - 15:45 | Author(s): C. Deschamps, A.A. Vaporciyan
- Abstract
- Presentation
Abstract:
The following is in part the STS, TSDA and AATS combined response to ACGME (collated and written up by Dr. Ara Vaporciyan) regarding the effect of Duty hour regulations on resident education in Thoracic Surgery in North America. A greater reliance on midlevel providers and physician extenders. This has impacted the profession in terms of additional cost from their much higher salaries, which are anywhere from 50% to 100% higher, but also a subtle but steady transfer of bedside teaching previously focused on the trainee to bedside teaching focused on the mid-level provider. Limited exposure to our field. Our profession still fills the bulk of its training position from general surgery graduates. Duty hour restrictions have contracted the ability of those programs to provide elective rotations in thoracic and cardiac. Limited exposure translates into limited interest and diminished applications. Quality of Surgical and postoperative teaching. This is where we have felt the greatest impact. We, like all surgical professions, have developed an increasing variety of procedures necessitating expansion of our case log requirements. This puts pressure on trainees to participate in every available case. Appropriate cases are harder to find due to increasing case complexity and outcome reporting. Therefore, the inability to scrub on just one or two of these cases can be significant. While some large surgery programs have implemented float pools to ensure that all cases provide someone a learning experience most CT training programs are small and cannot implement that solution Even more difficult to overcome is when a trainee misses a rare postoperative event. As a high acuity specialty our patients will frequently develop rapid changes in their condition which, if not recognized, can quickly become catastrophic. Most occur in the immediate postoperative period at night. The use of mid-level providers and other services to cover call in an effort to preserve a trainee’s ability to do cases the next day prevents them from taking part in the bedside assessment and management of these rare events. One solution is to lengthen training to allow more opportunities but there is concurrent pressure to reduce what is already one of the longest training paradigms (up to 9 years for congenital surgeons without considering any time for research). Alternatively simulation has been used but these are expensive and are not easily implemented at all programs.. Finally, issues of patient safety and outcomes. While there is no clear study demonstrating documented impact on patient safety there are many surveys of resident and faculty perceptions of patient safety. The majority of these, especially in surgery, have shown that the perception is that safety is compromised. The increased number of handoffs, especially of high acuity cases, is frequently the target of that perception. The subtle aspects of the intraoperative findings cannot always be accurately communicated in a handoff. While patient safety data is not conclusive there is data on worse outcomes in spinal and meningioma surgery post implementation of duty hour regulations. These data may serve to corroborate the perceived concerns.
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Author of
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-007 - Analysis of RNA Sequencing Data along with PET SUV-max Can Discover Novel Gene Sets Which Can Predict Surgical Outcome of NSCLC (ID 5404)
14:30 - 14:30 | Author(s): Y.T. Kim
- Abstract
Background:
Recent development of NGS technology provides a better understanding on the molecular mechanism of the cancer. A comprehensive analysis algorism of NGS data along with various clinical phenotypes and clinical outcome may lead discovery of novel molecular mechanism of cancer biology. It has been suggested that the preoperative SUV of the PET-CT is related to the aggressiveness of the cancer. We hypothesized that the identification of genes that were related to the PET SUV-max would lead a discovery of novel genes which could predict long-term outcomes of patients of non-small cell lung cancer.
Methods:
We set a 51 adenocarcinoma and a 101 squamous cell carcinoma patients cohort, whose cancer and normal tissue whole transcriptome sequencing data were available. The RNA sequencing fastq files were aligned on the reference genome (http://grch37.ensembl.org/) and the differential expressions were analyzed using tuxedo protocol (TopHat 2.0, Cufflinks 2.2.1). Visualizations of differential expressions were presented with CummeRbund R-package.
Results:
Based on the preoperative PET-CT SUV-max, patients were classified as "Low" (SUV≤3), "Intermediate" (SUV 3-10), and "High" (SUV>10) groups. Using the tuxedo RNA analysis tools, we selected 31 genes which showed significantly different expression of RNAs between "Low" and "High" groups in adenocarcinoma and between “Intermediate” and “High” groups in squamous cell carcinoma. By comparing expression levels of those 31 genes according to the development of recurrence, we could identify two sets of genes (COL2A1, BPIFB2, RYR2, F7, HPX, AC022596.6 and H19 for adenocarcinoma; BPIFB2, AC022596.6, ANKRD18B, GCLC, HHIPL2, COL2A1 and DPP10 for squamous cell carcinoma) which were related to the development of recurrence. Figure 1
Conclusion:
Our results suggest that it is necessary to set a comprehensive analysis algorithm of the NGS data along with various clinical phenotypes of the patients, for the discovery of clinically meaningful molecular mechanisms of the cancer.
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P3.04 - Poster Session with Presenters Present (ID 474)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.04-018 - Recurrence Dynamic of Completely Resected Non-Small Cell Lung Cancer in Perspective of Follow-Up Surveillance (ID 4850)
14:30 - 14:30 | Author(s): Y.T. Kim
- Abstract
Background:
There is no clear evidence or consensus on the modality and frequency of follow-up surveillance after complete resection of non-small cell lung cancer (NSCLC). Understanding of recurrence dynamic is essential to establish more efficient surveillance strategy. We investigated recurrence dynamic in completely resected NSCLC to propose a reasonable surveillance strategy.
Methods:
A total of 950 patients who underwent complete resection of NSCLC from 2006 to 2009 were reviewed retrospectively. Clinic-pathological data including follow-up surveillance records were obtained. All patients were completely followed until October 2015. Pathologic stage I, II, and IIIa NSCLC were included in the analysis. Mode of detection and the chronological pattern of recurrence were analyzed.
Results:
The median follow-up duration was 72 months. Recurrences were detected in 259 patients (27.2%) and freedom-from-recurrence rates were 78.2% at 2 year and 69.9% at 5 year. Recurrence was detected by routine follow-up study in 227 (85.7%), and by symptoms in 32 (12.7%) patients. In 65.5% patients, recurrence was detected by computed tomography and 26.2% was detected by positron emission tomography. The median time-to-recurrence was 1.1 year in entire recurrence group. Median-time-to- recurrences were 1.5 year in stage I (106), 1.0 year in stage II (61), and 1.1 year in stage III (92). There was no significant difference in chronological trend between the three stages (p=0.26). The cumulative rates of recurrence were 41.7%, 73.8%, and 91.1% at the 1st, 2nd, and 3rd year. Chance of recurrence dropped below 5% after 3 years and the probability of detection of recurrence was 8.6%. (Fig.1) Figure 1
Conclusion:
Chronological patterns of recurrence of NSCLC does not different between stages and majority of recurrences were detected within postoperative second year. The probability of recurrence were significantly reduced after second year regardless of stage. Intensive surveillance until postoperative second year and less intensive surveillance from third year is a reasonable stratege.
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SC30 - Novel Approaches and Regulation in Surgical Education (ID 354)
- Event: WCLC 2016
- Type: Science Session
- Track: Surgery
- Presentations: 1
- Moderators:D. Grunenwald, Y.T. Kim
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall C8
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SC30.02 - Animal Models for Training of Thoracic Surgeons (ID 6727)
14:50 - 15:10 | Author(s): Y.T. Kim
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
