Professor Yin-Kai Chao: art of surgery—the journey of a thoracic surgeon

Prof. Yin-Kai Chao (Figure 1) is a board-certified surgeon pioneering in minimal invasive esophagectomy. His innovative surgical methods as well as his experienced techniques have gained him recognition and many awards both home and aboard, including Young Investigator Award, Outstanding Research Award, International Scholarship, and President Award for six consecutive years.

Figure 1 Professor Yin-Kai Chao.

I met Professor Yin-Kai Chao during the 4^th Oriental Congress of Thoracic Surgery (OCTS) 2017 in Shanghai, China and was honored to interview him. Please check the video for more information (Figure 2).

Figure 2 Professor Yin-Kai Chao: art of surgery—the journey of a thoracic surgeon (1). Available online: http://www.asvide.com/articles/1739

The perspective and recognition of a good surgery

Prof. Chao explained that esophagectomy is a very complicated procedure, with the past mortality rate after surgery being almost 5–10%. In order to reduce the surgical mortality, the minimal invasive surgery (MIS) was introduced. However, after 20 years there’s still no evidence supporting that this approach is superior to the traditional procedure. When we reviewed previous surgeries, we have found many controversial points especially the definition of complications, mortality and readmission. Costs increase when patients need more therapies and medical resources. To balance these factors, Prof. Chao pays a special attention to the comparison between medical cost and survival. He believed that a “good” surgery should consider many essential factors, such as complication, cost and survival. In addition, Prof. Chao also emphasizes the importance of identifying the esophageal cancer risks at an early stage, as well as the importance of unplanned readmission after surgery to reduce medical cost.

The journey to be a thoracic surgeon

Prof. Chao shared his vivid memories of when he was at Chang Gung University, expressing his gratitude to the system as well as Chang Gung Memorial Hospital. He agrees that its free style encourages students to try many things and inspires their freethinking. Prof. Chao enjoys this atmosphere as it always stimulates him to do and experience with new things. However, as the saying goes, “Life is a beautiful journey, full of joy and pain.” Prof. Chao explains when they tried to develop some new technique, the learning curve was quite steep as they might spend a lot of time but could not see a little improvement or any result. Every time he encounters this kind of situation he would like to stop for a while, contemplate, review the case and then start again. There is always a solution. What you learn in one failure you utilize in your next success.

The prospects for development in Asia

Prof. Chao points out in Asia, especially in China, there are a wide variety of thoracic diseases. When comparing the Asian to the U.S. and European patients, there are many differences in histological subtype and disease behavior. However, we still do not have our own guideline for treating our patients to provide high level evidences.

Acknowledgements

On behalf of the editorial office of Journal of Thoracic Disease (JTD), I would like to extend my gratitude to Prof. Chao for sharing his opinions with us. Special thanks also go to my colleague Lynn Ma in assistance of transcribing the interview.

Footnote

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

References

1. Zhou S. Professor Yin-Kai Chao: art of surgery—the journey of a thoracic surgeon. Asvide 2017;4:425. Available online: http://www.asvide.com/articles/1739

(Science Editor: Silvia Zhou, JTD, jtd@amepc.org)