Contemporary Trends in the Thoracic Surgery View to the History, Perspective

Overview

The development of thoracic surgery in Czechoslovakia is very closely connected with the 1^st Medical Faculty of the Charles University in Prague. The first Czech surgical clinic was established in Prague at this medical faculty in 1882. Professor Vilém Weiss was the first Head of the clinic. The second surgical clinic in Prague was established in 1922 and Docent, later Professor, Academic Jiří Diviš was the second Head of this clinic. Jiří Diviš is rightfully considered the founder of the Czechoslovak school of thoracic surgery.

Whereas pulmonary tuberculosis was the main problem thoracic surgery faced in the first half of the 20^th century, pulmonary carcinoma is the main issue addressed in thoracic surgery in the second half of the 20^th century and currently. What new treatments can we currently offer our patients? Bronchoplastic procedures (so-called sleeve resections) have developed and carcinomas of the tracheobronchial tree – carina – can be treated in a similar manner. Development in the technology has brought staplers – machines for surgical suture. Staplers allow performing volume reductive pulmonary resections as one of the treatment options for advanced pulmonary emphysema. Introduction of the pulmonary transplantation method in practice on 22. 12. 1997, when Professor Pafko and his team performed the first pulmonary transplantation in Czech republic, was a major breakthrough in pulmonary surgery. The minimal invasive technique for thoracic surgery has developed further. Videoassisted

thoracoscopy is now an integral part of thoracic surgery. Introduction of PET – CT examination brought great benefit to a wide range of medical disciplines, including thoracic surgery.

Where may the future development in surgery and thoracic surgery take us? We are finding that specialisation is vital in the development of all surgical disciplines. In certain borderline or technically complex operations, thoracic and mediastinal surgery requires cooperation with cardiac surgeons. Thoracic diseases should therefore be centralised in centres with sufficient experience and resources for further development of the discipline.