History

III. the surgery clinic of the 1st Faculty of Medicine of Charles University (then the Faculty of General Medicine) was founded on September 1, 1957. At the time of its establishment, it was located at Londýnská Street No. 15 in Prague and was part of the premises of the General University Hospital (VFN) on Charles Square, in which also housed I. and II. surgery clinic 1.LF UK.

prof. MD Josef Pavrovský, DrSc.The first principal III. surgical clinic became prof. MD Josef Pavrovský, DrSc. (1909-1974), originally a student of prof. Jiráska from the I. surgical clinic VFN. In the 50s, he held the position of chief surgeon of Czechoslovakia and led a surgical clinic in Pilsen. His goal - and the purpose of returning to Prague - was to become the head of the First Surgical Clinic. This happened to him after the forced departure and retirement of prof. Jiráska succeeded in 1958. For the development of III. surgical clinic, so prof. During his approximately one-year stay, Pavrovský was not very important, most of his colleagues (e.g. thoracic surgeons Prof. Lichtenberg, doc. Pešek, doc. Fanta) transferred with him to the I. surgical clinic. After his departure, III. surgery lost the status of a clinic and until 1967 was just a department of the I. surgical clinic.

doc. MD Olga VanechkovaAt the head of the clinic, or the department was replaced by prof. Pavrovsky in 1958 doc. MD Olga Vanechkova (1909-1983), close associate and deputy of prof. Divided into II. VFN surgical clinic. Prof. Jiří Diviš, student of prof. Rudolf Jedlička (founder of the II surgical clinic), was a leading representative and founder of Czech thoracic surgery. The transfer of several of his students (in addition to doc. Vaněčková, also prof. František Řehák and doc. Václav Šmat) to III. the surgical clinic together with the later development of the thoracic surgery program thus enables the current III. consider the surgical clinic as a direct continuation of the Diviš and Jedliček surgical schools. From the beginning, the work of the clinic was general (abdominal) surgery and also traditionally traumatology. Representative doc. Vaneček was a dr. Miloš Vrbka, former head of the trauma department of the First Surgical Clinic. Doc. Zdeněk Bureš (1925-2002) founded the colorectal surgery program. Doc. Vaněčková became famous mainly for her esophageal surgeries. She was the first in our country (and one of the first in Europe) to save the life of a newborn with esophageal atresia with a timely operation. In addition to congenital defects of the esophagus, she also operated on carcinomas of the esophagus (resection from left-sided thoracotomy) and tracheoesophageal fistulas. After retiring in 1974, she continued to work at the surgical clinic.

Prof. MUDr. Frantisek Rehak, DrSc.Prof. MUDr. Frantisek Rehak, DrSc. (1927-2008) led the clinic in 1974-1992. From the beginning of his career, he has been involved in thoracic surgery. His candidate dissertation (1966) was on "Surgical Biopsy of the Lung". The habilitation thesis (1968) was entitled "Some problems of the diagnosis and surgical treatment of lung tumors." The doctoral dissertation from 1979 had the topic "Surgical biopsy, resection and transplantation of the lungs." He was appointed professor of surgery in 1982. Under his leadership, the clinic further developed esophageal surgery (he was the first in Czechoslovakia to remove the thoracic esophagus without opening the chest), lung surgery (in the clinic he introduced the resection of lung tumors including lymphadenectomy) and mediastinal surgery (together with Dr. Šmat he introduced the surgical treatment of thymomas in myasthenia gravis and together they wrote a monograph " Surgery of the lungs and mediastinum" (1986). New endoscopic diagnostics were promoted during the 70s. Prof. Řehák developed the technique of mediastinoscopy and thoracoscopy (diagnostic thoracoscopy with lung biopsy was performed from 1976). He was also in the research team of VÚTRN (Research Institute tuberculosis and respiratory diseases) in Bulovka, Prague, which was established in the 70s by the Ministry of Health to develop an experimental lung transplant program. Experiments on dogs were evaluated successfully, but their clinical application was possible only after the discovery and introduction of effective immunosuppressants. Prof. Řehák was one of the few advantages of Czech surgical clinics that remained in a leading position after the revolutionary social changes of 1989. He knew how to stand up to political pressures, protected his colleagues and never allowed the hierarchy of the clinic to be governed by political involvement. In 1990, he was elected chairman of the Czech Surgical Society JE Purkyně.

prof. MD Pavel Pafko, PhD.The successor of prof. He became Řeháka in 1992 prof. MD Pavel Pafko, PhD. (*1940). He underwent training in the entire breadth of abdominal surgery, he was devoted to traumatology of the musculoskeletal system (he was the head of the traumatology department at the clinic) and finally he was hired by prof. He selected Řehák for his chest team. Thoracic surgery then became his main specialty, and in 1996 President Václav Havel chose him as his surgeon for lung cancer. This made Prof. Pafko is a well-known expert in the media, but the public also noted the inadequate premises and conditions in which the clinic is located. It was still considered a detached workplace of the 1994st surgical clinic of the VFN, with an inadequate spatial arrangement of the building, inferior technical and instrumental equipment, unavailable complement (for CT, even acute patients had to be transported by ambulance to the VFN) and other specialties (cardiac surgery, pneumology, ARO). Such a position could not prof. to suit Pafko when he wanted to follow up on the attempts of prof. Reháka with lung transplants. The future transplant doctors learned surgical technique at the Allgemeines Krankenhaus (AKH) in Vienna under Prof. Walter Klepetek since 1997. In 1, for the above reasons, the entire III. the surgical clinic of the 22st Faculty of Medicine of the UK moved to the newly built section for adults in the Motol General Hospital. It left the trauma program and became an abdominal, thoracic and transplant surgery clinic. The first lung transplant was performed here under the guidance of prof. Pafka performed on December 1997, 41 in a 6-year-old patient with idiopathic pulmonary fibrosis. It was a left lung transplant, the patient lived another 22 years after it. Unilateral lung transplants are currently performed only exceptionally, the method of choice being bilateral sequential lung transplantation. The main indications are the terminal phase of lung diseases in COPD, idiopathic pulmonary fibrosis, cystic fibrosis and pulmonary hypertension. The first combined heart and lung transplant in the Czech Republic was performed on November 2007, 49 in a XNUMX-year-old patient with a congenital heart defect complicated by severe pulmonary hypertension, the procedure

 performed by doctors of IKEM Prague, AKH Vienna and Thomayer Hospital Prague under the guidance of prof. Jan Pirek.

prof. MD Robert Lischke, Ph.D.Prof. MD Robert Lischke, Ph.D. (*1966) has been leading the clinic since 2010 and continues in the line of prof. Puff. At the clinic, he develops a thoracic surgery and transplantation program and chooses the path of specialization - the division of doctors into individual specialist teams - transplant, thoracic, esophageal, colorectal, hepato-pancreato-biliary, endocrine surgery and others. In addition to operating, specialized teams are also responsible for monitoring patients in specialized outpatient clinics, where both pre-operative examinations, preparation and indications for procedures, as well as post-operative monitoring take place - in the case of malignant diagnoses in close cooperation with oncologists and radiologists through regular weekly multidisciplinary meetings - oncoboards.
III. the surgical clinic performs lung transplants as the only workplace in the Czech Republic, it also performs them for patients from Slovakia. Currently, around 50 lung transplants are performed annually. On November 29, 2014, a second heart and lung block transplant was performed in the Czech Republic in a patient with cystic fibrosis and a failing left heart chamber, again in cooperation with IKE.
On the one hand, the clinic is a workplace that performs a wide range of procedures in the entire abdominal and thoracic surgery, including both elective and acute surgery, on the other hand, the centralization of difficult procedures is promoted. This applies in particular to resections of the lungs, esophagus, rectum, thymectomies and extirpations of the parathyroid glands, where the number of procedures performed by the clinic meets the requirements of so-called high-volume centers. The establishment of the Center for the Treatment of Soft Tissue Sarcomas by Prof. Lischkem with the establishment of a sarcoma group at the clinic. Patients are thus provided with comprehensive treatment of sarcomas of the limbs and trunk (retroperitoneum, chest wall, mediastinum), including metastases.
It goes without saying that the penetration of mini-invasive procedures in individual programs is increasing. In addition to regular laparoscopy and videothoracoscopy, the clinic has been performing robotic colorectal surgeries since 2018 and robotic lung resections (RATS) since 2020. Other robotic procedures are esophageal resection, thymectomy and distal pancreatectomy.

Prof. MD Pavel Pafko, PhD.

prof. MD Josef Pavrovský, DrSc.doc. MD Olga VanechkovaProf. MUDr. Frantisek Rehak, DrSc.

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