India has recently taken over the position of being the most populous country in the world. At the same time, over the last three decades, non-communicable diseases continue to increase their dominance over mortality and morbidity of the population as a whole. While ischemic heart disease remains the number one cause of mortality (Fig. 1), it is alarming to note that three of the six top causes of death are from respiratory diseases. Even in the realm of cancer, lung cancer is increasingly being detected and now stands as the foremost cause of cancer mortality among Indian males (Fig. 2). The old training ground of thoracic surgeons, tuberculosis, is on the rise, with multidrug-resistant tuberculosis rearing its ugly head.

Fig. 1
figure 1

Trends in causes of mortality in India. Reproduced from Institute for Health Metrics and Evaluation. http://www.healthdata.org/

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Fig. 2
figure 2

Ranking of cancer incidence among males in India. Reproduced from Globocan 2012. http://globocan.iarc.fr/

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While these astounding facts are concerning, what is alarming is the context in which they exist. The proportion of health care spending remains among the lowest in countries with similar economic size. Of particular relevance to the Indian Association of Cardiothoracic and Vascular Surgery, the number of surgeons with specific training in general thoracic surgery and in the care of these problems is small. Given the enormity of cardiovascular disease burden, cardiothoracic surgeons in India have focused on cardiovascular pathology. However, the statistics presented above mandate that cardiothoracic surgeons now focus their substantial skill and labor to the management of patients with lung pathology as well.

It is with the intent of reinvigorating the discussion of general thoracic surgery that this special issue was commissioned by the Editor-in-Chief, Dr. O.P. Yadav. The issue contains expert reviews of several important topics in the field of thoracic surgery by leaders in the field. While no means a comprehensive review of the field, we hope that the excellent manuscripts presented here serve to rekindle interest in this important field among the august audience of the journal.