Newswise — SAN DIEGO, CALIF: When the first edition of Schwartz’s Principles of Surgery was published in 1969, the surgical profession was drastically different than it is today. CT scans, MRIs, and cancer staging did not exist. Radical mastectomy, a procedure to remove the whole breast as well as chest muscles and lymph nodes, was a common treatment for breast cancer that is no longer performed today. The only organ that had been transplanted successfully was the kidney. Now, almost a half century later, the landmark textbook’s editor-in-chief, ACS Past-President Seymour I. Schwartz, MD, FACS, will recognize the upcoming 50th anniversary of the book during the American College of Surgeons Clinical Congress 2017. Dr. Schwartz and other experts will reflect on advances in surgery over the last 50 years, and speculate on its future over the next 50 years.

This Clinical Congress marks 50 years since Dr. Schwartz completed the manuscript for the First Edition, so he thought this year was a good time to review its content. Dr. Schwartz asked experts at the University of Rochester, where he is celebrating his 60th year on the faculty, to look at each of the book’s 52 chapters and determine what areas had significantly changed and what information was no longer accurate. The results, Dr. Schwartz said, were dozens of pages of material that reexamine what the authors wrote 50 years ago. The publisher, McGraw Hill, will create a folio of the collected material, which will be given to people who purchase the Eleventh Edition when it is published in the next couple of years.

During the special session at Clinical Congress, “I thought it would be interesting to define the changes, and let the audience know about some of the most significant ones,” Dr. Schwartz said. For example, there used to be no other treatment for acute appendicitis besides removing the appendix, and now some cases can be treated with antibiotics.

“Fifty years ago, there was very little imaging, there were really only two chemotherapy drugs, and they didn’t have diagnostic tests—opening the patient up was the diagnostic test,” said David C. Linehan, MD, FACS, a cancer surgeon and chair of the department of surgery at the University of Rochester Medical Center, N.Y., who will co-moderate the session with Dr. Schwartz. In the cancer chapter of the First Edition, which Dr. Linehan was assigned to review, there was a whole paragraph about whether a physician should even disclose to the patient that they have cancer, since there was a belief that it might be too upsetting for the patient and make the outcome worse. “That belief would be scoffed at today.” Dr. Linehan said.

Other speakers include John Fung, MD, FACS, chief of transplantation at the University of Chicago Medicine and a mentee of Dr. Schwartz; and Ryan Fields, MD, FACS, an associate professor of surgery at Washington University School of Medicine, St. Louis, and a mentee of Dr. Linehan.

During the second part of the session, panelists will speculate on what the next 50 years may bring to the surgical profession. Dr. Linehan said he expects the trend of minimally invasive and robotic operations to continue. He also noted that surgeons will become better able to select patients likely to benefit from certain treatments by looking at biomarkers. When he operates on patients with pancreatic cancer, Dr. Linehan said, “80 percent of patients I operate on recur. If we knew who would recur, we could avoid surgery, or if we had better systematic chemotherapy, that could be a more effective treatment.” Dr. Schwartz agreed that minimally-invasive operations, particularly the growth in popularity of laparoscopic gallbladder removal in the 1990s, have “totally transformed the field,” and will likely continue to do so in the years to come.

 “All the things that we take for granted in our practice now, these guys didn’t have 50 years ago, so it’s kind of fun speculating where we’ll be,” Dr. Linehan said. He added that, in addition to celebrating the textbook, the session would also be an opportunity to honor Dr. Schwartz, who has a “history and legacy of training leaders in surgery” at the University of Rochester.

The 50th Anniversary of Schwartz’s Principles of Surgery session will be held Tuesday, October 24 from 11:30 am-12:30 pm at the San Diego Convention Center, Room 20BC. A video-based education session, Icons in Surgery II, will also honor Dr. Schwartz, and Patricia Numann, MD, FACS, on October 25. The video session will be held from 11:30 am-12:30 pm in Room 33ABC.

 

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About Seymour Schwartz, MD, FACS

Seymour Schwartz, MD, FACS, is a distinguished alumni professor of surgery at the University of Rochester Medical Center. He received a bachelor of science degree from the University of Wisconsin, Madison, in 1947, and a medical degree from New York University College of Medicine in 1950. In 1957, Dr. Schwartz completed his surgical residency training at the University of Rochester School of Medicine and Dentistry. Although he performed many types of operations, Dr. Schwartz’s major clinical impact was in the field of hepatobiliary surgery. He became an ACS Fellow in 1959. The First Edition of his textbook, Schwartz’s Principles of Surgery was published in 1969, and the book is now in its Tenth Edition. Dr. Schwartz was editor-in-chief of the first seven editions of the textbook, which sold more than half a million copies and was translated into nine languages. Dr. Schwartz was also Editor-in-Chief of the Journal of the American College of Surgeons from 1997-2004. He served as ACS President from 1997-1998, and was the recipient of the ACS Distinguished Service Award, the College’s highest honor, in 1986. In addition to his surgical career, Dr. Schwartz continues to be a prolific writer. He has written five books on the mapping of America.

 

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients.  The College is dedicated to the ethical and competent practice of surgery.  Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients.  The College has more than 80,000 members and is the largest organization of surgeons in the world.  For more information, visit www.facs.org (.)