University of Michigan. Section of Thoracic Surgery.

Thoracic surgery developed as a specialty at the University of Michigan after 1920 with the arrival of Dr. John Alexander who instituted the nation's first residency training program in thoracic surgery.

The world's second pneumonectomy was performed by Dr. Cameron Haight who joined the staff in 1931. Surgical treatment of tuberculosis was the initial focus, gradually giving way to cardiac surgery. In 1954 Haight became head of the Section.

The University of Michigan Section of Thoracic Surgery was an outgrowth of the growing specialization within the field of surgery which occurred after 1900. Rapid advances in surgical knowledge and techniques led to the development of surgical sub-specialties. Although operations on the chest such as the drainage of empyema and lung abscesses had occasionally been performed in the University Hospital, it wasn't until 1920 that thoracic surgery began to emerge as a specialty at the University of Michigan.

In 1920, John Alexander came to the University of Michigan at the invitation of Dr. Hugh Cabot and was given the assignment of developing a clinic in thoracic surgery. Alexander quickly established the University of Michigan as a major center for the study and practice of thoracic surgery, and the publication of his book, The Surgery of Pulmonary Tuberculosis, in 1925 was considered a landmark and did much to stimulate interest on the subject. Shortly before the publication of his book Alexander contracted tuberculosis, a condition that although arrested, would continue to plague him.

In 1927, the first thoracoplasty for tuberculosis in Michigan was performed at the University Hospital, and soon after Alexander limited his work entirely to thoracic surgery. In 1928 Alexander established the nation's first residency training program in thoracic surgery. Although tuberculosis was on the decline, it remained a formidable disease and was the major focus of thoracic surgery. In 1928 there were over 3,000 deaths from tuberculosis in Michigan. An arrangement was worked with the Michigan State Sanatorium at Howell in which the thoracic surgery staff members became consultants to the sanatorium. Two floors were added to the University Hospital in 1930 and 1931 for the care of patients with pulmonary tuberculosis. The number of patients referred to the university for surgical treatment of diseases of the chest continued to grow steadily such that by 1931 it was necessary to add to the thoracic surgery staff.

Cameron Haight joined the staff in 1931, and the following year the university instituted the first two-year training program in thoracic surgery. Haight became a leading surgeon in thoracic surgical techniques, and performed the first pneumonectomy in the Western Hemisphere and the second in the world. The University of Michigan played a major role in the development of thoracic surgery as it came of age as a specialty during World War II. Following the war, the discovery of effective anti-tuberculosis drugs reduced the need for the resection of pulmonary tissue. Gradually the sanatoriums emptied and new developments in thoracic surgery replaced the many operations for tuberculosis.

In 1954 Alexander died and was succeeded by Haight as head of thoracic surgery. The first open heart operation at the University of Michigan was performed in 1956 and soon cardiac surgery became the most important part of the section's activity. Michigan quickly became one of the major centers in the country for the surgical treatment of heart disease, particularly congenital heart disease. With cardiac surgery firmly established, members of the section turned their attention to heart and lung transplantation and in 1968, Edward Kahn performed the first of several successful heart transplants.

Haight died in 1970 and was succeeded by Herbert Sloan as head of the Section of Thoracic Surgery. The section developed specialties for the surgical treatment of diseases of the esophagus and conducted ongoing research in heart and lung transplantation, cardiac valve homografts, and myocardial preservation. In 1984 Mark Orringer replaced Sloan as head of the Section of Thoracic Surgery. The clinical services continued to grow. In 1990 the Section performed a total of 1709 thoracic surgical operations, and from 1984 to 1990 the Section performed 173 heart transplants. The section continues to maintain a position of national and international leadership in the field of thoracic surgery.

For further information regarding the development of the Section of Thoracic Surgery at the University of Michigan, reseachers are advised to consult Horace Davenport's book, University of Michigan Surgeons 1850-1970 Who They Were and What They Did. (Ann Arbor, MI: Historical Center for the Health Sciences, University of Michigan, 1993).