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Editorials |
Thoracic Surgery, Hospital Universitari Sagrat Cor, Barcelona, Spain
Received 10 November 2009; received in revised form 14 December 2009; accepted 16 December 2009.
* Corresponding author. Address: Viladomat 288, 08029 Barcelona, Spain. Tel.: +34 629360124; fax: +34 934052649. (Email: lmolins{at}hscor.com).
Ladies and gentlemen; dear members and guests,
It is a great honour for me today to be able to stand on this podium and deliver my presidential address. I want to talk about our Society, the European Society of Thoracic Surgeons (ESTS), which I have had the honour to serve as founding member, councillor, regent and now as president. I will try to take you on an exciting journey from the origins of our Society through its life right up to its present, one of real adulthood.
Let's look at the past. I clearly identified myself with the statement of the German medical figure Theodor Billroth. The history of our Society needs to remember its origin and the influence of many European surgeons when dealing with the problem of attempting to open the chest. After the failed attempt of the Polish surgeon Block in opening the thorax, in 1904, Ferdinand Sauerbruch, from the surgical clinic of the famous von Mikulicz-Radecki in Germany, introduced his method of low-pressure ventilation and became the acknowledged leader of thoracic surgery in Europe.
1. European thoracic surgery club
In the past century, there were many important thoracic surgeons around Europe, but there was no European Society. In the mid-1970s, Abbey Smith organised the Coventry Conference and Francisco París, founder and honorary member of ESTS, organised on 12 and 13 March 1976 a historical meeting in Valencia to which many of the eminent thoracic surgeons of the epoch were invited. Amongst these were Kevyan Moghissi and Jean Paul Witz, together with Francisco Paris, considered the ‘three Musketeers’ founders of the future European Thoracic Surgery Club. The first meeting was held on Sunday 16 September 1979 at Castle Hill Hospital in the UK, organised by Keyvan Moghissi. As we will see during this presentation, we needed outstanding leaders to move the world of general thoracic surgery and get others to jump on the bandwagon and follow the leaders! In 1980 new members were introduced to the Club, most of whom, 13 years later, would become the leaders of our European Society of Thoracic Surgeons. As a premonitory situation, Ingolf Vogt-Moykopf was in charge of exploring the possibility to evolve from a Club to a Society in the future. The scientific communication between thoracic surgeons was essential so the European Thoracic Surgery Club created, ‘The Euro Thoracic Surgery Vision’, with Paco París as editor and Hermes Grillo and Mario Milano as consultants. The open relation with thoracic surgeons worldwide led to the publication in 1986 of the first volume of International Trends in General Thoracic Surgery, edited by Delarue and Eschapasse and demonstrated the excellent relationship between European and North American thoracic surgeons, something that we can still feel today in this Mikulicz Room.
2. European Association for Cardio Thoracic Surgery
The need for more than a Club of Thoracic Surgery in Europe became clear with the foundation in 1986 of the European Association for Cardio Thoracic Surgery, under the leadership of Francis Fontan on the cardiac side and Keyvan Moghissi on the thoracic part. The initial steps of the Association were successful, but over the years, the need of a better profile of general thoracic surgeons was postulated, I have had the privilege of getting personal and written information from many of the people who were involved in what I call ‘pregnancy and delivery’ of the ESTS, mainly Francisco París, Michel Ribet, Toni Lerut and Peter Goldstraw, among others. According to their view, by the time of the 1990 EACTS meeting in Naples, thoracic surgeons were disillusioned with the thoracic content of the programme and saw no possibility of influencing change. In 1992, several thoracic surgeons sat around Ingolf Vogt-Moykopf in Geneva fighting for a bigger role in the Association with little result.
3. European Society of Thoracic Surgeons
In September 1992 many European thoracic surgeons received a fax from Ingolf Vogt-Moykopf asking for a vote for the foundation of an own European society for thoracic surgery and I had the privilege of becoming founding member of the new European thoracic society, together with 23 outstanding surgeons! (Fig. 1 ).
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Ingolf Vogt-Moykopf, the major proponent of the new Society, was elected president (Fig. 2 ) and the first executive committee was composed of 11 members with Peter Goldstraw as vice president, Toni Lerut as treasurer and Detlev Branscheid as secretary general. He did a great job arranging everything for the official registration and tax-free status of the Society with the German authorities. At the time of the Heidelberg meeting, there were 43 members, with 80 attendants and 82 communications presented. The day after, we were all very proud of the birth of the new society after a laborious 3-year pregnancy!
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Henry Ellis, from Boston, was elected the first honorary member of the Society and John R. Benfield, as corresponding member. During that year, Peter Goldstraw became president and J.M. Wihlm treasurer. Frau Johanna Bosse was incorporated as administrative secretary to the ESTS Office in Heidelberg. At that time, membership increased to 150 members. Peter Goldstraw proposed an international system of regents to facilitate communications with the membership. On 25 February 1995 the first 18 regents were appointed, initially for a period of 3 years. The editorial side of the Society was represented by the Newsletter and the first issue appeared in April 1995 with Tadeus M. Orlowski as editor. There were three issues each year and became autonomously financed.
3.3 ESTS 1995–1996
The third European Conference was held in Lausanne, Switzerland, in October 1995. It was organised by Dr Chapuis, and the attendance continued to increase. During the general assembly, the Society unanimously recognised the contribution of Ingolf Vogt-Moykopf in establishing the Society. Robert J. Ginsberg from New York was elected honorary member.
Giovanni Ferrante from Naples became President, and nine more countries were represented in our Society, a total of 25 with a membership of 221 thoracic surgeons. Peter Goldstraw was appointed as liaison officer between ESTS and the European Respiratory Society (ERS), beginning a friendly and scientific co-operation that still survives to date. ESTS was represented on the European Union of monospecialties (UEMS) and by those dates of October 1995, Toni Lerut presented a proposal for a unified European Board of Thoracic and Cardiovascular Surgery. On 24 June 1995 the question of a logo for our Society was discussed, and a number of proposals in varied styles were presented. The logo representing the tracheobronchial tree was unanimously agreed upon.
3.4 ESTS 1996–1997
In October 1996, Cordoba was the city where the fourth European Conference was held, organised by Javier Lopez-Pujol and his group. As many as 171 communications were presented and three honorary members elected: Eugene Reboud from Marseille, Henry Eschapasse from Paris and our first president, Ingolf Vogt-Moykopf. Francisco París became president, working hard with D. Branscheid from his position as general secretary, to increase membership up to 320 members.
On 26 October 1996, due to the good relations with our sister society, a Liaison Committee was established with EACTS, with the creation of scientific committees. The European Board of Thoracic and Cardiovascular Surgery fell also within the scope of this Liaison Committee. Toni Lerut focussed his energy on the place of General Thoracic Surgeons within the European Board. The aim was to harmonise the training and recognition of specialists in our field throughout Europe and, eventually, to obtain full recognition within the UEMS. It was important to take the initiative to organise our specialty in a better way and provide standard quality of surgeons that would enable free movement of surgeons and patients within Europe. The initiative got the full support of the three major European Societies within our field, EACTS, ESTS and ESCVS, and the Management Board had representation of all three societies and three co-opted members. For the first 5 years the Board accepted, without examination, senior members of the specialty who could apply for recognition under the ‘grandfather’ clause. Lorenzo Spaggiari was the first ESTS member recognised by the European Board of Thoracic and Cardiovascular Surgery and those accredited received a diploma recognising us as Fellow of the Board.
3.5 ESTS 1997–1998
The following year, the European Conference moved to Wroclaw in Poland, where Tadeusz Orlowsky organised a historical meeting, because at the end of it the first Thoracic Board examination took place. It was on 27 and 28 September that four thoracic surgeons received the Committee's European certificate. Harabumi Kato was admitted as corresponding member and a special Mikulicz Award was delivered to Dr Bernward Passlick (Germany) for the best-presented paper. A special ceremony was held in the famous Aula Leopoldina of the University of Wroclaw, where Griffith G. Pearson received his Honorary ESTS Membership (Fig. 3
). P. Goldstraw donated an ESTS stamp and T. Orlowsky a symbolic golden ‘Presidential Chain’ with the ESTS logo, which I have had the honour to wear during this past year.
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3.6 ESTS 1998–1999
The sixth European Conference was held in the Adriatic coast, with Janez Erzen as president of the conference. Participants of 19 countries presented 150 papers and the second Thoracic Board exam was organised. Since then, the thoracic part of the Board exam has been performed at our meetings. Francisco Paris, one of the main actors of the ‘pregnancy and delivery’ of ESTS, received a well-deserved honorary membership.
Tadeusz Orlowsky became president in Portoroz and Hans Beat Ris succeeded J.M. Wihlm as treasurer. An increasing number of members and activities made it necessary to improve the administrative structures with a professional secretariat.
Since its foundation in 1993, it was felt that a major journal was needed for implementing the credibility of the Society. One of the major achievements of the Society was to successfully conclude negotiations with the Editor-in-Chief of the European Journal of Cardiothoracic Surgery and with Elsevier to become the official organ of the ESTS. The first issue of the EJCTS to function as the joint official organ of the EACTS and ESTS was the September 1999 issue. An experienced surgeon was chosen to act as the first Thoracic-Editor – Jay Jeyasingham from Bristol. In that new era, the objectives of the newsletter were to act as a means of communication between the Society and its members.
3.7 ESTS 1999–2000
In 1999, the seventh European Conference on General Thoracic Surgery was held in Nancy, France, and was organised by Jacques Borrelly. For the first time a formal Scientific Programme Committee of the Society was constituted for the purpose of reviewing all the abstracts submitted and selecting those that were to be presented at the conference. Some of the 130 abstracts presentations where selected for journal publication on the EJCTS. Michel Ribet was elected honorary member.
After all his work on behalf of thoracic surgery in Europe, Toni Lerut became president of the ESTS in Nancy. To me, there is no doubt that the task of general secretary is one of the most important for the continuity of the Society. After 6 years serving as secretary, Detlav Branscheid left the council and I want to thank him for his hard work during those years. Richard Berrisford became the new general secretary and a worrying problem with the membership fee was updated: less than a third of ESTS members had been able to pay their fee. The secretariat adopted an e-mail address, and a website and domain were prepared by Tadeusz Orlowsky. He, with Peter Goldstraw, Heike Tomas and Richard Berrisford were elected new representatives for the EACTS/ESTS Liaison Committee and a Work Force was created to define the structure of a Thoracic Unit in Europe. Walter Klepetko, Tomasz Grodzki and J.F. Velly were the designated co-ordinators and they began to work in conjunction with EACTS representatives in the same way of Richard Berrisford with the European Thoracic Surgical Database Project.
3.8 ESTS 2000–2001
London was the venue of the eight Conference and Peter Goldstraw the Chair. For the first time the electronic submission of abstracts was used as well as for selected papers to be sent to the Editorial Office of the Journal. An annual ‘Brompton Prize’ was founded to distinguish the best thoracic presentation by an ESTS member at the Presidential Plenary Session, and came as a courtesy of the Trustees of the Fund chaired by Mr Peter Goldstraw. The first winner was our current general secretary and director of the Annual Meeting, Dirk Van Raemdonck. Joel Cooper was elected as honorary member at that meeting, participating in a symposium on LVRS and Transplantation.
Heikki Toomes was the next president in 2000, facing the problem of an increase in the annual fee due to the delivery of the journal to all members. The Society had 187 ‘paid members’ and a minimum of 400 were needed! The Secretariat moved to Exeter, UK, and Richard Berrisford proposed a new ESTS Constitution to apply for charity status in UK, to avoid having to pay VAT and tax. Due to the circumstance that both Councils of EACTS and ESTS elected Lisbon for holding the 2001 annual meeting and the closer collaboration in the past years, the first EACTS/ESTS Joint Meeting was approved.
3.9 ESTS 2001–2002
It was held in Lisbon in September 2001 and Vitor sa Viera acted as co-chairman of ESTS. The meeting was successful and Bernward Passlick was awarded with the Brompton Prize. Two outstanding thoracic surgeons were elected as honorary members, Mark Orringer from Ann Arbor and Andre Naef from Lausanne.
Pierre Fuentes became the new president and another key person was incorporated into the Administrative Secretariat since February 2001, Mrs. Sue Hesford, to whom I want to thank warmly for her dedication and professional work during the past 8 years.
To increase the implication of regents in the Society, Kalliopi Athanassiadi was appointed as the regents’ representative into the Council. That year a new journal was introduced: The Interactive Cardiovascular & Thoracic Surgery, with free access to the web and four printed issues of the journal. The work of the EACTS/ESTS Working Group on Structure of General Thoracic Surgery in Europe was concluded and has been a key document in the professional view of the optimal organisation of GTS in Europe [1].
3.10 ESTS 2002–2003
The ninth Conference was held in Istanbul in 2002, under the organisation of Semih Halezeroglu, and it was the largest meeting since the foundation of ESTS with 601 attendants. Thorsten Kruger from Lausanne was awarded with the Brompton Prize and Hermes Grillo and Leon Lacquet were elected as honorary members that year.
Ion Bellenis became president in Istanbul and during this meeting, membership increased significantly up to 342 members. The Charity Status was registered with the UK Charity Commission in December 2002 and a junior grade of membership was created to get closer to young thoracic surgeons. The society presented a new website homepage, a great advance in the communication with members and Richard Berrisford deserves to be congratulated for it! European Database continued to develop and in a meeting held in Monaco, it was agreed with EACTS to have at least two Joint Meetings, so ESTS would organise a new format of ‘Spring Meeting’. EACTS would make a contribution of € 150,000 towards the running of the ESTS Spring Meeting and the Secretariat.
3.11 ESTS 2003–2004
The second joint meeting was held in Vienna in 2003, with Michael Mueller as local organiser from ESTS. The attendance was difficult to calculate, but 470 thoracic surgeons were identified. Didier Lardinois from Zurich was awarded the Brompton Prize and no honorary member was elected that year.
The ESTS Presidency was honoured by Tomasz Grodzki and the figure of a minimum of 400 members needed to be in a good financial position was accomplished!
During that year, Tomasz Grodsky developed a new International Exchange Programme for surgeons visiting other units. Thirteen departments joined the Programme and up to now, 28 trainees from 15 countries have benefited from this opportunity. ESTS officers started to be invited by AATS and STS and had interesting talks with the officials of both Societies in Toronto recognising our Society, a leading voice for General Thoracic Surgery. An ‘Umbrella Committee’ for managing the future ESTS collaboration with EACTS was initiated, with the first meeting held in Washington. The proposition of a joint European Cardiothoracic School in Bergamo became a reality and many of us had the opportunity to act as teachers or as students, which reached a high level of satisfaction not only from a scientific point of view but also in a personal relation.
3.12 ESTS 2004–2005
The first Spring Meeting of ESTS was organised by Walter Weder in Zurich in March 2004. There was a question whether this format of meeting, along with the Autumn Joint Meeting in Leipzig, was going to be well accepted. A total of 300 attendants with an attractive programme and international speakers gave a positive answer! The Council of the ESTS decided to promote Working Groups between its members and Walter Weder organised a first workshop in Zurich dealing with lymph node staging in non-small-cell lung cancer. Richard Achatzy was the local representative of ESTS at the Joint Meeting in Leipzig, where Federico Venuta was awarded the Brompton Prize and Valerie Rush and Giovanni Ferrante with the honorary membership.
Walter Weder became president and Gaetano Rocco new treasurer after Hans Beat Ris finished his 6-year period. The worldwide expansion of the Society was clear with more than 500 members from 49 countries. The financial problem of the distribution of the journal within ESTS trainees was solved by Gaetano Rocco, who secured a 3-year sponsorship from industry, a very positive initiative for the future of ESTS.
At the April 2004 Umbrella Committee meeting in Toronto, the unanimous agreement was that EACTS and ESTS would enter into a partnership for 5 more years of Joint Meetings and ESTS Spring meetings, besides other agreements such as a single thoracic editor of the journal, the European Board, the European Database and the Bergamo School. Richard Berrisford, the driving force behind the database, suggested the setting up of an ESTS Database Committee to include Tom Treasure, Adelheid End, Alex Brunelli, Gaetano Rocco and himself. As from 1 January 2005, a new online Thoracic Surgical Database was available, and the risk of death following lung resection was published [2]. Richard and Kalliopi Athanassiadi collected information from regents about thoracic surgery in each country, with a view to building up a European Directory of Thoracic Surgery with a link on the ESTS website's homepage. More information for members was available, that being one of the aims of ESTS.
3.13 ESTS 2005–2006
Kalliopi organised the second Spring Meeting in Athens in 2005, while Ramón Rami-Porta was the ESTS representative in the fourth Joint Meeting in Barcelona. There, the first sponsored satellite symposium was organised, following a new closer relation with industry. Furthermore, the relations with worldwide sister societies were emphasised with the invitation to the 2005 Joint Meeting in Barcelona of an officer of AATS and the Japanese Society of Thoracic and Cardiovascular Surgery. Masahiro Tsuboi from Tokyo was awarded with the Brompton Prize and Alec Patterson, today's AATS President, received one of the honorary memberships. Jay Jeyasingham had finished his superb period as thoracic associate editor of the journal and he received a much-deserved honorary membership as well.
Important changes within the Council were seen in 2005: Semih Halezeroglu became president and Richard Berrisford ended his active and productive 6 years as general secretary, and the person elected was Dirk Van Raemdonck, our current and efficient general secretary. Erino Rendina was elected as the thoracic editor of the journal.
The society membership increased to 660 members and an addition of category of ‘senior’ membership was approved. The important Industrial Relations Committee incorporated Michael Mueller as new chairman. During the general assembly in Leipzig, the Nominating Committee rules for election to the Executive Committee were reviewed, with the five immediate past presidents and the current president as non-voting member. Full members of the society will propose candidates and nominations will be approved by Council before considering a voting in the general assembly. As requests for ESTS support for national and international meetings mounted, it was agreed to review the programme and speakers and, if approved, the logo and a membership mailing list would be send with a cost to be used for the funding of young surgeons for a travelling fellowship. An ESTS Metastasectomy Working Group was created and chaired by Dirk van Raemdonck with the intention of giving answers to the practice in Europe.
A survey among councillors showed unanimous support for continuing the fruitful partnership between EACTS and ESTS, in spite of the minor problems that were present, solved by dialogue between both parties. An example of that was the meeting that took place in Leuven on 17 December 2005 between the ESTS and EACTS presidents, the treasurers and the general secretaries. A document was written with two recommendations: (1) Both societies should collaborate on Autumn Joint meetings and ESTS Spring Meetings. (2) A financial agreement from 2006 to be extended over 3 years and reviewed each year. The ESTS Council approved the document and waited for the EACTS Council's approval. A membership survey was performed in 2005 and 252 members replied with 80% describing their practice as General Thoracic Surgery. We were also asked about ‘How important was for us that ESTS mainly represents General Thoracic Surgery as a specialty? And 96% thought that it was Important or Very Important. That survey was clear enough to consider our Society as the main representative of General Thoracic Surgery in Europe supported by the membership relation of our sister society, the EACTS, in which no more than 12% of their members were considered themselves general thoracic surgeons in two reports on 2002 and 2005 [3].
3.14 ESTS 2006–2007
In 2006, the third Spring Meeting was held in Romania; Cluj Napoca and Dan Nicolau was the organiser. As many as 180 thoracic surgeons attended the meeting and, for the first time, the financial balance was negative. Tomas Szoke from Hungary was the winner of the seventh edition of the Brompton Prize and a new Greek Pioneers’ Prize was offered to the best poster presentation, as courtesy of a fund chaired by Dr Kalliopi Athanassiadi, to honour the name of the first three Greek thoracic surgeons. The first award was granted to Goksel Kalaycy, from Istanbul. Peter Pairolero, a reference point in our specialty and a former president of STS, was elected honorary member at the EACTS/ESTS Joint Meeting in Stockholm.
Richard Berrisford became president and the Council had to deal with a conflict with EACTS. After some months, ESTS was informed that the Leuven document, approved on 17 December 2005, had been rejected by the EACTS Council. It was felt that the joint activities were fruitful for thoracic surgery in Europe, but the rejection of the document by EACTS needed a clear future direction of the next steps of our Society. The Council approved to hold one single scientific meeting in Leuven on June 2007 and to offer its membership an alternative platform for education. More than 700 thoracic surgeons were members of ESTS in 2006 and the interest in our society was increasing. An agreement was drawn between ESTS and ERS for a reduced fee for members of both societies and to organise joint sessions in coming, task forces to produce guidelines and other collaborations. Kalliopi left her position in the Council after a great job as regents’ representative and Danail Petrov from Bulgaria replaced her. On 12 May 2007, the first online council meeting was held on the ESTS Webex site. It is an excellent cost-saving tool for the Society and to maintain close contact between councillors to run the Society.
The Industrial Relations Committee chaired by M. Mueller approved three levels of sponsorship. Meanwhile, Treasurer Gaetano Rocco brought about two tremendous achievements: an agreement with industry that ESTS would receive € 300,000 per year in 3 or 2 years in exchange for satellite symposiums and other privileges. Needless to say, in the new situation those agreements brought an optimistic view as far as finances were concerned. In September 2006 and April 2007, the excellent job by the working group on lymph node staging, under the Chair of Walter Weder, was published in our journal as the first guidelines on intra-operative and preoperative lymph node staging for NSCLC, a reference point for all thoracic surgeons [4,5]. In an effort to modernise the structure of the ESTS, President Elect Gaetano Rocco created at the end of 2006 eight ‘Ad Hoc’ Committees to deal with a variety of issues regarding the thoracic surgical community. To the Committees instituted, after 1 year Training in Thoracic Surgery Ad Hoc Com was also created.
3.15 ESTS 2007–2008
The great responsibility for conducting the 2007 ESTS Conference in Leuven was Toni Lerut's and it became a great success not only as far as attendants – more than 600! – but also as far as industrial support (20 companies). It was a very important test that confirmed the implication of European general thoracic surgeons in ESTS, and that in turn provided confirmation of the role of the ESTS as an independent society.
This support was further confirmed by the 317 abstracts submitted, reviewed by 50 members, resulting in 131 presentations, a Joint Session with ERS, a postgraduate course, and an excellent industry-supported Techno College. Isabelle Opitz from Zurich was awarded with the Brompton Prize and Xavier D’Journo from Marseille with the second Greek Pioneers’ Prize. To stimulate research and participation in annual conferences, ESTS instituted two more prizes: The Young Investigator's Award for the best presentation on topics of clinical or experimental research, and the Covidien Prize to the most interesting case presentation. My colleague Juanjo Fibla from Barcelona received the first Young Investigator's award and Antigone Koliopoulo from Athens, the Covidien Prize. Peter Goldstraw, who not only was a founding member, but also as one of the real protagonists of our Society, was awarded with the honorary membership (Fig. 4 ).
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The society reached 769 members from 48 countries and a lower fee for members from low-income countries was enforced. Another action to bring the society closer to the membership was that the venue for future annual meetings should be proposed by members. The journal price decreased to € 70 instead of € 130 in exchange for 1000 copies and there was an increase of more than 100 GTS manuscript submissions in 1 year.
Michael Mueller, as treasurer, signed a contract with Mondial, a PCO based in Vienna, because of the Council decision that the ESTS annual meetings needed professional assistance. The need was also addressed for an ESTS trading company to get donations from industry without jeopardising the charity status, so contacts to do so began. Jaroslaw Kuzdzal proposed and worked on the edition of a European Textbook of Thoracic Surgery to provide a comprehensive educational facility but the difficulties in sponsorship have delayed this project, which is still in the ESTS’ agenda for the very next future. Co-operation with ERS had been closer every day and two ESTS–ERS Task Forces were launched. Gaetano Rocco was nominated the ESTS’ representative in the International Leadership Committee, with biannual meetings for addressing common problems or initiatives. Gaetano also presented an ESTS Project of co-operation with Industry for Educational Purposes, and this was in parallel with the proposal of Richard Berrisford: The ESTS Thoracic School.
One of the main aims of the ESTS is to provide high-quality educational opportunities for thoracic surgeons, so in February 2007 it was decided to establish the ESTS Thoracic School and to hold a theoretical part in Antalya, Turkey, organised by Semih Halezeroglu, and a practical course in Elancourt, the Covidien educational facility in France, conducted by Gaetano Rocco. He organised the educational platform opening event of the European School of Thoracic Surgery in Elancourt, France, October 2007 with the International Faculty involved in the School activities and with the representatives of the national thoracic societies, council and regents. It was really a successful event and the next courses for members were announced for April and September 2008. Lectures in Antalya were prepared by 70 European and international members from our Society in a very well-structured format. This course is preparing thoracic trainees for the thoracic exams organised by the European Board of Thoracic and Cardiovascular Surgeons. On November 2007, Semih as Antalya School Director and Richard as ESTS Educational Committee Chair organised the first theoretical course of the Thoracic School in Antalya, Turkey, with 48 students from 21 countries and nine lecturers. The experience for both attendants and teaching staff was very satisfactory indeed, and a new course was announced for March 2008. It was again an excellent and very well-accepted course by the 34 junior attendants, as well as for the six lecturers, in a very friendly atmosphere.
3.16 ESTS 2008–2009
Last year, the Conference was held in Bologna, with Sandro Mattioli as organiser. It was the second independent meeting of the ‘new era’ and, again, the main strength of the Society was demonstrated with the attendance of 635 surgeons and 194 presentations.
There were representatives from the many sister societies around the world outlining the important role of our Society in the thoracic surgical arena jointly with three Joint Symposia, two with ERS and one with European Society of Esophagology. The winner of the Brompton Prize was Elena Fernandez from Madrid and Douglas West from UK was awarded with the Greek Pioneers’ Prize. The Young Investigator's Award went to Kai Nowak from Germany and the Covidien Prize to Cliff Choong from UK. Toni Lerut was recognised as honorary member of our Society and he really deserves it as he is one of the European thoracic surgeons most actively involved in the defence of our specialty around Europe.
That year I had the honour of being elected president of our Society coinciding with an increase in membership of up to 889 members from 51 countries. Conversations with Douglas Wood, general secretary of the STS, have resulted in an STS/ESTS pre-agreement on bilateral benefits on membership, which will strengthen the relations between both sister societies even further. Since 2008, the Council decided to have on-site visits to the candidate cities to host the annual meeting. The natural consequence of ESTS’ independence since 2007 is the need for ESTS to have an ethically acceptable fundraising. As sponsoring payments might constitute a taxable trading activity of ESTS under UK Charity Tax law, the Trustees, together with the Treasurer and the ESTS Council, decided to establish a trading subsidiary in the UK, which was appropriately set up in February 2009 with Kostas Papagiannopoulos and Dirk van Raemdonck acting as directors.
A proposal to strengthen the Society by developing four director positions for 3 years tenure was proposed in Council and approved by the Assembly: Director of the Annual Meeting: Dirk van Raemdonck; Director of Thoracic School and Education: Gaetano Rocco; Director of Database: Alex Brunelli. The decision for Director of External Relations was postponed. Enriqueta Felip, Ramón Rami Porta and myself, on behalf of the Catalan Association for the Study of Lung Cancer, created last year a Travelling Fellowship offered by the ESTS to provide thoracic surgeons with a 3-month opportunity to visit medical institutions and learn valuable skills and techniques from some of the leading European thoracic surgeons. The first travel award will be granted during this meeting in Krakow. Two new international projects for Working Groups in Tissue Engineering and Thymic Tumors are pioneered by Gaetano Rocco and Federico Venuta, respectively, with the participation of surgeons from both sides of the Atlantic. Other projects were initiated: the ESTS–ERS Pneumothorax Project and the ESTS Project on definition and terminology for Minimally Invasive Thoracic Surgery.
Online information for members is increasing with the Directory of Thoracic Surgery and the ESTS Database Version 2 of the Lung Resection Risk Model project. I want to encourage all members to join in these Projects that Richard Berrisford and Alex Brunelli are leading now. The latter, developed a proposal of the ‘ESTS Institutional Accreditation for Units Practicing Thoracic Surgery in Europe’, focussed on quality surveillance and standardisation of processes. The need to co-operate in the education of health-care professionals treating malignant chest tumours is reflected in the organisation of educational meetings between the European Society for Medical Oncology (ESMO), the European Society for Therapeutic Radiology and Oncology (ESTRO), the European Respiratory Society (ERS) and the ESTS, like the European Multidisciplinary Conference in Thoracic Oncology (EMCTO) held in Lugano on May 2009.
The important role of the Thoracic School and its good acceptance by the attendants continued in another two editions of the practical course in Elancourt on September 2008 and March 2009, which I have had the privilege to participate. Two days earlier, I was also involved in the theoretical course in Antalya, very well organised by Semih and Richard, with the participation as lecturers, among others, of Tom Rice and Mark De Groot. I can confirm the good relationship between teachers and attendants in a nice friendly atmosphere. Moreover, the effectiveness of the School was confirmed with multiple-choice questions asked at the beginning and at the end of the course, with a very good progression.
3.17 ESTS 2009–2010
Marcin Zielinski and Jaroslaw Kuzdzal have organised this 17th Conference on General Thoracic Surgery in Krakow, the highest ever seen in number of abstracts submitted, members serving as reviewers and, of course, a record in attendants! The collaboration between AATS and ESTS has reached its highest level with yesterday's Joint Postgraduate Course along with other important Joint Sessions with ERS and with the International Society of Diseases of the Esophagus. The Techno Meeting will offer the opportunity to get involved in new technology, thus showing again industry's support to the ESTS. There will be several working group meetings and an important business meeting with the presidents of National Societies regarding the future of Thoracic Surgery in Europe. Fortunately, more and more prizes are offered by institutions and it was agreed that our own acronym, ESTS, will always be placed in front of all our prize names. Two new prizes and awards will be delivered tomorrow during the Gala Dinner: The ESTS-Grillo Award will be offered for the best thoracic presentation by an ESTS member at the Experimental and Innovative Work/New Techniques Session, a prize devoted to the memory of Hermes Grillo, a true master in this field. Clemens Aigner from Austria will receive the first ESTS–ACECP Travel Award and I hope that young surgeons will be attracted to this and other travel awards that our Society is developing, as visiting other institutions has always been for me a great learning experience. The enormous working capacity of Tom Treasure is well known and tomorrow he will be officially the 2009 ESTS Honorary Member.
Michael Mueller will become the new president of our Society tomorrow. He deserves this honour and I am sure he will continue the excellent work of my predecessors. Kostas Papagiannopoulos has been nominated as treasurer and, if approved tomorrow by the Assembly, he will continue developing the excellent work of Michael, in which he has been involved during the past year, mainly setting up the Trading Company.
We are currently 856 members and tomorrow 127 applications will be presented at the general assembly, so our membership will reach almost 1000!
ESTS School will run another course in Elancourt in October 2009 on minimally invasive lung surgery, organised again by Gaetano Rocco. This year ESTS has initiated a Travel Fellowship Programme to offer to 60 thoracic surgeons annually the opportunity to visit select European centres. Michael Mueller has been the promoter with an exclusive sponsor of this programme. Still on educational issues, G. Rocco has organised the first ‘Itinerant ESTS Expert Course’. There will be simultaneous, 2-day practical courses on TEMLA and VATS Lobectomy will be held on 22–23 October 2009 in Zakopane with Professor Marcin Zielinski and in Copenhagen with Professor Henrik Hansen, respectively. Another line of action in education has been followed after the initial proposal of Tomasz Grodzky to past presidents, that is, to create the European Society of Thoracic Surgeons’ Foundation for Research and Education, which could be sponsored by all members. The ESTS Fund is at its origin within the Past Presidents’ Working Group. Tomorrow, as new Past President, I will try to help Tomasz to make this excellent project for the members of our Society succeed. The new process of onsite evaluation of candidate cities to host our Annual Meetings began with the election of Krakow and is working very well, Valladolid being elected for 2010 under the organisation of Mariano Garcia-Yuste.
4. ESTS perspective
Today, the ESTS is the largest Society representing General Thoracic Surgery in the world, with almost 1000 members, with more than a hundred participating as regents, councillors or in the Ad Hoc Committees. Others have participate as conference organisers and reviewers (100 this year) serving to the success of our meetings as well. We are collaborating closely with the prominent International Sister Societies, the sponsoring of industry in training is growing and the Thoracic School is a reference point even for our transatlantic colleagues.
In 1992 ‘we had a dream’: the constitution of the European Union and a year after, a new dream was a reality: the European Society of Thoracic Surgery. As with the European Union, there were difficulties, as we all came from different countries and cultures, different languages and different trainings, but with a common wisdom – the development of the specialty of General Thoracic Surgery, to stimulate close co-operation among its members and exchange views and experiences among specialists within and outside Europe [6–8]. My dream is the so-called United States of Europe with two common languages: scientific co-operation and friendship!
We cannot forget our role in the fight against lung cancer, since the overall survival is similar to 50 years ago! Smoking cessation and early detection opens a new opportunity of collaboration with other organisations involved such as ERS and IASLC.
A 92% 10-year survival after surgical treatment of stage I in screened patients in the I-ELCALP study gives an optimistic view of the future if, finally, the cost–benefit issue supports the convenience of screening, applied to the leading cause of cancer death in the world.
To conclude, I want to thank my team, a real group of great people who join their efforts working hard towards the most valuable daily commitment: our patients. I do not want to finish this presidential address without offering a tribute to my family – without them, I could have never accomplished my professional career! Cuca, my wife, has been my valuable support during 26 years of my life and our four daughters, an incredible gift from God! Thanks to them for their daily love and the stability they have given to me. I want to thank my large family as well, with my parents as real pater and mater familias, as they are still the mirror I look myself in, when I need to search for the best answer.
To prepare this presidential address, I have used personal documents, newsletters, council and regents’ minutes, and the valuable help from Sue and most of the presidents and general secretaries of ESTS. Thanks to all of them! Finally, I want to thank the Society for having granted me the opportunity to serve as president, a service that has been the greatest honour in my professional career.
Thank you very much!
Footnotes
Presented at the 17th European Conference on General Thoracic Surgery, Krakow, Poland, May 31–June 3, 2009.
References
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