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The past, present and future of thoracic surgery

Publication |
2009

Abstract

The development of thoracic surgery in former Czechoslovakia was very closely connected with the 1st Faculty of Medicine, Charles University in Prague. Whereas pulmonary tuberculosis was the main problem thoracic surgery faced in the first half of the 20th century, pulmonary carcinoma has been the main issue addressed in thoracic surgery in the second half of the 20th century and currently.

What new treatments can we currently offer to our patients? Bronchoplastic procedures (so-called sleeve resections) have developed and CEircinomas of the tracheobronchial tree - carina - can be treated in a similar manner. Development in the technology has brought staplers instruments for surgical suture.

Staplers allow to perform volume reduction pulmonary resections as one of the treatment options for advanced pulmonary emphysema. Intioduction of the pulmonary transplantation method into practice on 22 December 1997, when Professor Pafko and his team performed the first lung transplant surgery in the Czech Republic, was a major breakthrough in pulmonary surgery.

The minimal invasive technique for thoracic surgery has also developed. Video-assisted thoracoscopy is now an integral part of thoracic surgery.

Introduction of PET/CT examination brought a great benefit to a wide ramge of medical specialties, including thoracic surgery. Where may the future development in surgery and thoracic surgery take us? It has been shown that specialization is vital in the development of all surgical specialties.

In certain borderline or technically complex operations, thoracic and mediastinsd surgery requires cooperation with cardiac surgeons. Patients with thoracic diseases should therefore be referred to specialized centres with sufficient experience and resources for further development of the discipline.