Wed, 07/20/2016

Thorax Centre - Competence Centre for Thoracic Surgery

The Department of Thoracic Surgery of the Lung Clinic Berlin, which belongs to the PGD International network of clinics was certified as a Competence Centre for Thoracic Surgery as the first clinic in Germany for the 3rd time in a row.

In order to be eligible for certification the applying clinic has to meet the elaborated catalogue of requirements set up for a “Thorax Centre - Competence Centre for Thoracic Surgery” by the German Society of Thoracic Surgery (DGT). The catalogue was evaluated for the first time in 2008 with three pilot clinics in Germany, including the Lung Clinic Berlin. When certifying a thorax centre significantly higher standards are applied to the number of cases treated at the thoracic surgery departments than in the certification of a lung cancer centre. This is happens for the reason that all diseases in need of a thoracic surgical intervention as benign changes (pneumothorax, empyema, evaluation of interstitial lung disease) as well as malignancies that do not originate in the lungs (e. g. metastases or thymic carcinoma etc.) are included and not alone the operations and methods of treatment that are the sole assessment in the case of lung cancer patients.

In addition to reviewing the structural quality (number and qualification of specialists of Thoracic Surgery, sufficient availability of operating rooms and ICU capacity, qualification and training of the medical and nursing staff) quality comes also with the survival or the number of aerenchyma conservative surgeries or the rate of R0 resections to be crucial.

In this regard the rate of pneumonectomy in anatomic resections is only at 4.2% at the Lung Clinic, which is significantly lower than generally reported in the literature (<25%). The R0 rate in Stage I and II of a lung carcinoma is 98.8% and 97.6% (the requirements are </ = 95%) and 90.0% at stage IIIA (requirement </ = 85%). In certified centres clinical trials must be offered: here 193 patients were recruited for studies in the observation period.

For the certification it will also be checked whether SOPs (Standard Operating Procedures) for important processes are implemented (e. g. therapy planning, preoperative management, pain management, etc.) or for postoperative complications (intraoperative bleeding, postoperative stump insufficiency, severe postoperative infections, etc.).

To undergo certification forces us at the hospital to think critically about our habitual procedures and adapt them - in the interest of the patients - to the demands of the professional associations. That this pays off do shows the fact that since the initial certification of the Lung Clinic as lung cancer centre in 2009, the number of patients that will be presented in the tumour conference has increased so much that it is now necessary to hold a tumour conference four times a week, in which in 2014 more than 1,600 patients were presented and for every each of them an individual treatment regimen was designed.

We see certification as an important element to scrutinize our own actions critically and continually evolve by this outside input. Nationwide there are now 44 centres certified as "cancer centre" and 14 centres as "Thorax Centre - Quality Centre for Thoracic Surgery" but only the Lung Clinic Berlin has passed these audits already the 3rd time in a row successfully.

The Department of Thoracic Surgery at Lung Clinic Berlin is headed by Dr. med. Gunda Leschber, Chief Physician and Specialist in Surgery and Thoracic Surgery