Thoracic surgery in Brazil: an overview.

Brazil is an emerging country with continental proportions, being one of the largest in the world. As big as its territory, are the complexities and singularities within it. Brazilian thoracic surgery reflects the picture of this unique giant, with all its virtues and problems. This peculiar framework of thoracic surgery in Brazil unfolds that the surgeons are usually well trained and can perform this specialty with technical and scientific excellence, making the country to play a true major role in Latin American thoracic surgery. Nevertheless, the chronic social imbalance present in every aspect of the Brazilian daily life hampers this ultra-specialized workforce to be equally and universally available for every citizen, in every corner of the country. Lung transplantation and minimally invasive approaches (including robotics) are performed by many surgeons with good results, comparable to those observed in high-income countries from North America, Europe and Asia. However, these procedures are still performed more often in centers of academic excellence, located at the main cities of the country, which also reflects an unequal access to these approaches within the Brazilian territory. The aim of this paper is to present a broad overview of the practice of general thoracic surgery in Brazil, as well as its main idiosyncrasies.