I spent a very pleasant and interesting morning talking to the enthusiastic and charming young surgeon, Dr. Carlos Cesar Ochoa Gaxiola in Mexicali, Mexico. Dr. Ochoa is my favorite type of surgeon to interview. He loves what he does despite the challenges it sometimes presents (due to limited local resources such as PET/CT modalities*). His enjoyment of surgery and caring for his patients is obvious – and he readily invites me to round with him, and see his daily practice. Unfortunately, on this occasion, I am unable to do so.
Just a year and a half since completing his thoracic surgery residency, and Dr. Ochoa has made Mexicali, (the capital of Baja California) his home. As the only full-time thoracic surgeon* in this city of almost one million residents – Dr. Ochoa stays busy operating and seeing patients at both the general hospital and the ISSSTecali hospital system.
Since much of his practice is working in public facilities, Dr. Ochoa spends much of his time caring for the poor, and the underserved patients of Mexicali – who have little access to preventative health and wellness therapies. He reports that he performs a large volume of decortications and other procedures to treat empyemas and similar endemic diseases of poverty. This includes surgical treatments for tuberculosis, which remains a serious health problem in Mexico.
During our interview, we discussed his work with tuberculosis patients many of whom have multi-drug resistant tuberculosis. (The emergence of MDR and XDR strains of tuberculosis has become a rapidly spreading health threat not just in the middle east and Asia but in the United States and Mexico, particularly in border towns.) In adjoining Calexico, the University of San Diego has a tuberculosis project to help identify and aggressively treat these resistant strains. While this program has been successful in encouraging compliance and adherence to complicated (and expensive) long-term drug regimens, it also highlights the importance of thoracic surgery in the treatment of this disease. Dr. Ochoa reports that he frequently treats pulmonary complications of this [TB], and other chronic lung infections. He performs many of these operatives to prevent constrictive complications and to restore patients functional status/ prevent disability.
He also performs the entire spectrum of other thoracic surgery procedures including other types of pulmonary resections for the treatment of cancer(s), traumatic injuries to the chest, thymectomies and other mediastinal procedures, esophagectomies and tracheal surgeries. He embraces the use of minimally invasive procedures including dual port thoracoscopic procedures, and performs the majority of his cases by VATS.
He prefers the transhiatal approach for the majority of esophageal cases since it limits the development of catastrophic complications such as mediastinitis from anastomosis leak. He reports that he does not get do as many esophageal cases as he would like since the majority of the cases performed locally are done by general surgeons.
This afternoon, Dr.Ochoa is giving a presentation at the Mexican Society of Pulmonologists and Thoracic Surgeons on the topic of surgery for the treatment of COPD.
Dr. Carlos Cesar Ochoa Gaxiola, MD
Thoracic Surgeon
Av. Madero 1059
Mexicali, Baja California
Tele: 686 – 552 – 5436
Brief Biography of Dr. Carlos Cesar Ochoa Gaxiola
Dr. Ochoa is certified nationally as a cardiothoracic surgeon, though he explains that similar to the United States – the majority of programs are combined – and he subspecialized in Thoracic Surgery. He states that current board certifications in Mexico make no distinction between subspecialties. He has also received additional certification by the National Counsel of Thoracic Surgery, and is a member of multiple specialty organizations including: the LatinAmerican Association of Thoracics (ALAT), Sociedad Mexicana de Neumologico y Cirugia de Torax.
Dr. Ochoa attended medical school at the Universidad Autonoma de Baja California. He completed his general surgery residency (four years) at the Hospital General del Estado; in Hermosillo, Sonora. He then performed his thoracic surgery fellowship at the Instituto Nacional de Enfermedades Respiratorias (INER). This four-year program is one of the only Thoracic Surgery specialty training programs in Mexico. He had received additional training in bronchoscopy, and video assisted thoracoscopy (VATS).
He has presented multiple case reports at national conferences.
Publications: (note: I was unable to find live links for all of his publications).
Mucormicosis Pulmonar: Presentación de un caso. Neumología y Cirugía de Tórax 2009; 68: 78-81. Download pdf.
Additional references and information:
University of San Diego Tuberculosis program – podcast of this story.
Notes:
* The nearest PET/ CT scanner in Baja California is located in Tijuana.
** There are two cardiothoracic surgeons who divide their time between Tijuana and Mexicali, who primarily perform cardiac surgery. Dr. Ochoa sometimes partners with these surgeons on more complex, and complicated cardiac and thoracic cases.
Thoracic Surgery 