The development of General Thoracic Surgery

摘要

At the beginning of the 19th century, the development of chest surgery was initiated by the purposeful experimentation of French, German, and other European surgeons. The discovery of the low-pressure method is linked with names such as Brauer, von Mikulicz, and Sauerbruch in 1904. The accurate experiments of the last-mentioned led to the development of the decompression chamber - Sauerbruch′s cabinet. The high-pressure method and the introduction of endotracheal anaesthesia by Kuhn in Germany, - Auer, and Meltzer working in the Institute of Physiology at the Rockefeller Institute - followed in the years between 1901 and 1909. Advances in anaesthesia with endotracheal ventilation made increasingly extensive thoracic surgical interventions possible, as positive pressure could be maintained in the lungs and collapse on opening the chest avoided. Following the first atypical pulmonary resections for tuberculosis at the end of the 19th century by Delorme, Doyen, and Tuffier in France - Heidenheim undertook the first lobectomy in Worms in Germany in 1901. In 1931 Nissen successfully performed the first pneumonectomy on a child with bronchiectasis and Graham, in 1933, carried out the first pneumonectomy to remove a bronchial carcinoma. Anatomically isolated preparation of the hilar structures was undertaken by Rienhoff in 1933, whereby considerable reduction in complications was achieved. Lung surgery progressed rapidly so that the anatomical segmental resection was employed clinically by Churchill and Belsey in 1939 in England. Edwards established the thoracic tradition of the Brompton School in London, and his first assistant Price Thomas performed the first bronchial sleeve resection in 1947. An important prerequisite for lobectomy was the introduction of suction drainage of the pleural cavity for the reexpansion of the residual lung. This was achieved using the siphon drainage developed by von Bülau in 1890. After the Second World War General Thoracic Surgery in Germany advanced. Resection procedures became increasingly important.