Thoracic surgery
Welcome to the Department of Thoracic Surgery at
University Hospitals Bristol NHS Foundation Trust. These web
pages are designed to provide an overview of our services for
prospective patients, their families and carers. If you are
coming into hospital for surgery, they will give you an idea of
what will happen during your stay, and how you can help contribute
to your recovery.
The department deals with the surgical management of chest
disease. Tumours, infections and other disorders of the lungs, the
chest wall, the lung lining (the pleura), the mediastinum (middle
of the chest) and diaphragm are investigated and treated.
Surgery for
heart and oesophageal
(gullet) disease takes place elsewhere in the
hospital.
We have a particular interest in minimally-invasive surgery
(also as video-assisted thoracic surgery, or VATS), including VATS
lobectomy. Other areas of interest include endobronchial
interventions for severe emphysema, airway stenting and chest
wall surgery.
Our catchment area is large and covers Avon, Somerset,
Gloucestershire, Wiltshire and north Dorset. We also receive
referrals from elsewhere.
In 2010 we adopted the principles of enhanced recovery for all
patients undergoing thoracic surgery. The key to its
success is patient involvement, which we believe leads to better
outcomes. Implementing enhanced recovery pathways is one of many
improvements the NHS is undertaking. Modern surgical and
anaesthetic techniques play a part but, more importantly, patients
are encouraged to take an active part in their own recovery.
We hope that the better prepared you are the easier and more
successful this will be.
This website does not provide medical advice. If you think
you may require chest surgery, talk to your doctor in the first
instance.
Location
We are based in Bristol Royal Infirmary. In-patients are
looked after on Ward A700 (level 7 of the new Zone A ward block),
with high dependency and intensive care provided on ward A600 (ICU)
if required.
Children's thoracic surgery takes place at the Bristol Royal
Hospital for Children. Children are usually looked after on
Ward 31, or in the adolescent unit on
Ward 35. This area is specially designed for patients
aged 11-16.
Referrals
Most patients will be referred by a respiratory physician (chest
medicine specialist), often through one of the lung cancer
multi-disciplinary teams (MDTs) which we serve. Some patients
are referred directly by their general practitioner or by other
specialists. Currently, our surgeons routinely attend lung
cancer team meetings at hospitals in Yeovil, Taunton, Weston, Bath,
North Bristol (Southmead Hospital) and Gloucester, in addition to
Bristol Royal Infirmary.
The department also welcomes referrals from hospitals and GPs
outside our normal referral area. Please see the contact
details section for how to make a referral.
Audit and quality assurance
The department sends data to several internal and external
bodies to ensure the quality of our services.
Data on our surgery for lung cancer is reported to the NHS
England Lung Cancer Clinical Outcomes Publication, and is available
through the SCTS.org
website.
Information on lung cancer care in our region is collected by
the
National Lung Cancer Audit. You can access this
data using the Roy Castle lung cancer smart map
here.
We also send annual activity data to the UK
Society for Cardiothoracic Surgery, for both our cancer and
non-cancer surgery.
Enhanced recovery
This is based on the following principles:
- Patients are in the best possible condition for surgery
- Patients have the best possible management during and after
their operation
- Patients experience the best post-operative
rehabilitation
We will talk to you about the operation beforehand, what to
expect and how to aid your own recovery afterwards. For major
operations, this will include goals to aim for every day.
These are outlined in the patient diary (see useful information section).
The preoperative assessment team will discuss this with you and
provide additional information.
Further information about the national ERAS programme can be
obtained
here.