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Session fetes Seymour Schwartz, founding editor of iconic surgery text

OCTOBER 24, 2017
Clinical Congress Daily Highlights, Tuesday Second Edition

The American College of Surgeons held a special session on Tuesday honoring one of its true legends: Seymour I. Schwartz, MD, FACS, founding and longtime editor of the world’s leading surgery textbook, Schwartz’s Principles of Surgery. The text is now in its 10th edition and celebrating the 50th anniversary of its establishment in 1967.

Dr.  Schwartz, 89, delivered a lively talk highlighting the session, chaired by a protégé, David Linehan, MD, FACS, University of Rochester Medical Center, Rochester, NY. Dr. Schwartz chose to chronicle extraordinary progress in fields that did not exist when Schwartz’s Principles began: liver transplantation and molecular diagnostics of solid tumors.

“We stand on the shoulders of giants,” said Dr. Linehan, who succeeded Dr. Schwartz as chairman of the Department of Surgery at the University of Rochester Medical Center. “I don’t think you can find a taller one than Dr. Schwartz.”

Schwartz, who was ACS president in 1997–98, began by recalling the start of the eponymous textbook, which he led for 35 years through seven editions during a time of breathtaking advances. 

“The other five associate editors all had administrative positions, and so they designated me as the one to be traumatized as the editor-in-chief,” he recalled. Though he claimed to hate the phrase “paradigm shift,” there were many in his time. For example, the first surveillance for malignancy, the PSA test for prostate cancer, was introduced in 1984. He cited changes in engineering, biochemistry, and genetics that have resulted in more sophisticated, non-invasive diagnostics “which changed the very profile of lesions subject to surgical excision,” as well as engineering advances that enabled minimally invasive surgical procedures.

He noted that the TIPS procedure to reduce vascular resistance in the liver replaced his own favorite procedure, the flow shunt, which he said hasn’t been done in the past two decades at his hospital.

He then modestly took personal responsibility for a list of entries in the textbook that were later revealed to be erroneous, such as a declaration that antibiotic use was unnecessary in a patient with acute appendicitis because the appendix must be removed as soon as possible. The editorial board of the first edition accepted a statement by contributors that adenomatous polyps of the colon “had negligible attention for subsequent malignancy.”

Textbooks, he said, should be considered evanescent. “Print often, if not usually, outlasts the facts that it promulgates,” said.

The two guest speakers at the session, besides Dr. Linehan, were John Fung, MD, PhD, FACS, University of Chicago, Chicago, IL, where he is chief of transplant surgery, and Ryan Fields, MD, FACS, Washington University in St. Louis, MO, a cancer surgeon. Fung did his surgical residency at Rochester University, where Dr. Schwartz was chairman of the Department of Surgery from 1987 to 1998.

Dr. Fung discussed the history of liver transplant surgery and Dr. Fields focused on changes in diagnostics and therapeutics in solid tumors, especially melanoma.

Additional Information:
The Special Session, 50th Anniversary Celebration of Schwartz's Principles of Surgery: First Edition: A Retrospective and Futuristic View, was held October 24, at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA. Program, webcast and audio information is available online at FACS.org/clincon2017.

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