On the introduction of a presidential system

Ichiro Yoshino, M.D., Ph.D.

Professor and Chairman, Department of General Thoracic Surgery, Chiba University Graduate School of Medicine.

I would like to extend my greetings and report that I was elected as the 4th President at the first Board of Directors meeting held in Nagasaki City and online this year.
Since joining in 1992, I have been trained as a thoracic surgeon, researcher, and educator by the Japanese Association of Chest Surgery (JACS) to this day. For the last 10 years, I have been making efforts to manage the JACS as an officer under the guidance of the first president, Professor Kondo, the second generation, Professor Okumura, and the third generation, Professor Chida. In 2018, I was given the honor and valuable experience of hosting the 35th Scientific Meeting of the JACS. Through these experiences, I am deeply grateful to the Society, and have come to think about the future of thoracic surgery and the role of the Society.

I recognize that the history of the JACS is the history of establishing the medical category of general thoracic surgery and making society recognize the existence of thoracic surgeons. In 1983, the year before its establishment, only 10 universities had departments centered on general thoracic surgery or those of general thoracic surgery, but as of April 2021, this number increased to 54. General thoracic surgery was established as a specialty board system of the Japan Surgical Society in 1989, and the JACS joined the Japanese Association of Medical Sciences in 1991, and in 2008, the advocacy of general thoracic surgery was approved under the national system, and then departments of general thoracic surgery were installed in many hospitals. Even in the novel medical specialist system supported by the government, it is one of my most important duties for general thoracic surgery to be officially approved as a subspecialty of surgery, and I am confident that the foundation of the JACS will be even more solid. On the other hand, from a global perspective, the European Society of Thoracic Surgeons (ESTS), an international organization of general thoracic surgeons centered in Europe, was behind the establishment of the JACS in 1993. It was established as a branch of the European Association for Cardio-Thoracic Surgery. Japan is thus pioneering and playing a major role in the acquisition of an international identity in the relatively new areas of general thoracic surgery (Thoracic Surgery, General Thoracic Surgery, Chest Surgery). We would like to further contribute to the establishment of the international status of general thoracic surgery.

The number of general thoracic surgery procedures is increasing year by year, and 103,422 cases were registered in 2018. Of these, 45,871 were for primary lung malignancies, but just as the incidences of metastatic lung tumors, mediastinal tumors, and pneumothorax / empyema are increasing, so is the importance of general thoracic surgery in society. Furthermore, for primary lung cancer, immune checkpoint inhibitors and molecular-targeted drugs are being incorporated into perioperative therapy, and it will be imperative for us to consider case / surgical procedure selection and outcome evaluation. In addition to conventional VATS, advances in technology/techniques, such as RATS and uniportal VATS, provide opportunities for the diversification and deepening of our surgical medical care. Through projects with the JACS, in addition to joint projects with related organizations, we will further educate and research on these new types of general thoracic surgery.

Lastly, the last year and six months have been a period in which the lives, groups, and activities of people around the world have been at the mercy of the new corona pandemic. Our academic activities were also greatly influenced such as scientific meetings, education-related seminars, summer schools, and specialist examinations. The 37th Scientific Meeting Chairman, Shunsuke Endo, and the 38th Chairman, Takeshi Nagayasu, made great efforts, and it is commendable that they demonstrated stunning resilience that will lead to the future of the JACS. In this way, it is necessary to respond flexibly and powerfully in the corona era, and I would like to think together with everyone about "things that change, things that must be changed, and things that must not be changed". I would like all of the members to cooperate with the activities of the JACS.