Special article: a brief history of pneumonectomy. 1999.
The ineluctable conclusion to be drawn from this article is that thoracic surgery could not develop without endotracheal ventilation. What is astounding is that this technique, known since the 16th century and perfected in the late 19th century, was ignored and in fact rejected by surgeons [4]. The negative effect that Sauerbruch had on the development of thoracic anesthesia was well stated by Comroe: "An impressive piece of hardware, backed by a highly prestigious designer, can hold back progress for decades" [49]. Before the formation of the AATS, there was no forum for the discussion of methods for solving the problems of pulmonary resection and anesthesia. Experience gained in the animal laboratory was largely ignored and not applied to pneumonectomy in humans. Ligation of the pulmonary artery does not initiate the clinical course of massive pulmonary embolism. In the absence of infection, concern about the postpneumonectomy space is groundless. Preresection phrenic nerve crush and pneumothorax are unnecessary, as are attempts to stabilize the postpneumonectomy mediastinum by adjusting intrapleural pressure or by thoracoplasty. It behooves thoracic surgeons to heed Comroe's comment: "Finally, what are we, with our infinite wisdom and magnificent technical advances, doing today that will appear primitive, curious or even stupid 50 years from now?"
Fell
Stanley C
SC
Department of Cardiothoracic Surgery, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008175:Lung Neoplasms / Q000266:history / Q000601:surgery; D011013:Pneumonectomy / Q000266:history* / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000266:history / Q000601:surgery