60 Years – and Still Counting

The year 1953 saw the birth of a new scientific German language journal, dealing primarily with thoracic surgery and called “Thoraxchirurgie” accordingly. Operations on the lung, esophagus, and chest wall, as well as the occasional mediastinal tumor had become more and more common in the years following the Second World War. Initiator and first editor was Karl Vossschulte, head of surgery at Giessen University Hospital, who was very fond of operations involving the chest and contributed to their further refinements. He had been trained by Emil Karl Frey, himself a Sauerbruch scholar, in Munich. As early as 1939 Frey had published a book called “Die Chirurgie des Herzens” (Surgery of the Heart),[1] although this particular specialty was virtually non-existent at that time. Frey, however, had performed the first closure of a patent ductus arteriosus during his time in Düsseldorf in 1938. Robert E. Gross of Boston fame is more commonly remembered for this pioneering deed during the same year because he was quicker to publish it.[2]

It was quite befitting, therefore, that Vossschulte invited his teacher to write the first article for his new journal, dealing with esophagoplasty.[3] The foreword, on the other hand, was a contribution by Rudolf Nissen, another Sauerbruch scholar and surgical giant at that time.* He is well remembered even today for his fundoplication. This foreword makes fascinating reading, because Nissen elaborates on the amazing development of thoracic operations, at the same time emphasizing that the foundation of this new publication could not be considered “as a step towards the creation of a specialty of thoracic surgery.”[4] He continues to praise the value of general surgery and broad experience, closing with an appeal that “the journal should encourage a general surgeon to take a more active part in thoracic organ surgery research and practice than has been the case up to now.”[4]

By the time Nissen died in 1981, history had taken a completely different course. With cardiac and vascular surgery waiting just around the corner this seems inevitable in retrospect. Already in the third issue of “Thoraxchirurgie” the heart had entered the scene,[5] and by the end of its first year, the journal had published several rather comprehensive articles dealing with a variety of cardiac pathologies, both congenital and acquired.[6] [7] [8] It should be remembered that on May 6th of the same year John H. Gibbon had performed the first successful ASD closure with the help of a heart-lung-machine in Philadelphia. Cardiac surgery was here to stay.

After a decade's publishing, in issue 1/1962, the editor (still Vossschulte) and publisher (still Thieme) announced a change of the journal's title to “Thoraxchirurgie und Vaskuläre Chirurgie,” paying tribute to the increasing success of vascular surgery, but for whatever reason still officially ignoring the heart, although there was a lot of cardiac content. The heart claimed its right only in 1978, when HG Borst renamed the journal “The Thoracic and Cardiovascular Surgeon,” concomitantly turning it into a full English language publication.[9]

Sixty years down the road The Thoracic and Cardiovascular Surgeon continues to publish almost equal numbers of original articles both on thoracic and on cardiac subjects, complemented with vascular and basic science topics. For historic reasons it seemed only appropriate to compile a print issue dealing exclusively with thoracic surgery to serve as an official birthday announcement. This is where we all came from, and the editor will make sure to continually provide an even mix. We have even been receiving more papers on esophageal surgery recently, but that is a different story. Watch this space.

*Historical Note

Emil Karl Frey (1888–1977), an officer in the medical service during World War One (WW I), became director of the Düsseldorf Medical Academy in 1930. A member of the NSDAP since 1939, he was advisory surgeon to the Deutsche Wehrmacht. He moved to Munich in 1943 and there remained director of the surgical department of the University Hospital until his retirement in 1959.

Rudolf Nissen (1896–1981) was severely wounded as a soldier during WW I, serving in a medical service battalion. Being of Jewish descent he voluntarily left Germany in 1933. He became professor of surgery at Istanbul University in Turkey, but emigrated to the USA because of health reasons in 1939. There he held various positions in Boston, Brooklyn, and New York City. In 1952 he became professor of surgery at Basle University, Switzerland, where he retired in 1967.

Both surgeons were scholars of the famous surgeon Ferdinand Sauerbruch in Munich, and both followed him to Berlin when he took over the Charité in 1927. Sauerbruch, Frey and Nissen can be called the godfathers of German thoracic surgery. The two disciples started their careers in an almost identical way. That their biographies took completely different turns after 1933 is an impressive reflection of German history. It is interesting to see them re-united on the first few pages of this journal.

• References

• 1 Frey EK . Die Chirurgie des Herzens, Stuttgart, Enke, 1939
• 2 Gross RE, Hubbard JP. Surgical ligation of a patent ductus arteriosus. Report of a first successful case. JAMA 1939; 112: 729-731
• 3 Frey EK. Intrathorakale oder antethorakale Oesophagoplastik. Thoraxchirurgie 1953; 1 (1) 2-4
• 4 Nissen R. Geleitwort. Thoraxchirurgie 1953; 1 (1) 1
• 5 Steinhardt O. Klinisches und Experimentelles zum Herzstillstand. Thoraxchirurgie 1953; 1 (3) 222-227
• 6 Hueck O. Der kongenitale Aorta-Pulmonalis-Defekt. Thoraxchirurgie 1953; 1 (4) 365-372
• 7 Nick J. Zur Einmündungsweise der Lungenvenen in den linken Vorhof. Thoraxchirurgie 1953; 1 (5) 387-402
• 8 Rinck H, Venrath H, Valentin H. Schmitz Th. Diffusionsstörungen in den Lungen bei alten Insuffizienzen des linken Herzens und bei der Mitralstenose nebst einigen Bemerkungen zur Operation der Mitralfehler. Thoraxchirurgie 1953; 1 (5) 403-410
• 9 Heinemann MK. 1962. Thorac Cardiovasc Surg 2012; 60 (3) 179-180