Preface

The specialty of pediatric surgery was developed in Children’s Hospitals, themselves an outgrowth of 19th century philanthropy made both possible and necessary by industrialization. It was the pediatricians who sought out those surgeons they knew, with whom they could get along, and who were interested in the problems of children. Like early thoracic surgery, which dealt so much with the complications of tuberculosis, and like pediatrics, it took a special dedication on the part of the surgeons to commit their careers to children. The patients of these dedicated surgeons and pediatricians were most often of lower socioeconomic status, and before the establishment of Medicare in the United States, they included a large number of “charity cases.” It was the American Academy of Pediatrics which provided the first home for organized pediatric surgery in the Surgical Section.

Although social, economic, and even political forces may have originated specialization in the surgery of children, it has flourished with the definition of a contiguous specialized field of knowledge, including basic sciences such as embryology and developmental biology. Clinically, the diseases of childhood may be more uncommon than those of adulthood, but they are also quite different and certainly demand careful study by specialists.

The field of pediatric surgery has distinguished itself from adult general surgery in many ways, but one that is particularly notable is that pediatric surgery includes thoracic surgery, whereas pediatric cardiac surgery has become a separate specialty, limiting itself almost entirely to the heart.

This issue of Seminars in Pediatric Surgery demonstrates the achievements of pediatric surgery. The authors address issues of lung disease which are peculiar to children from both the basic science point of view and the clinical point of view providing both an understanding of the problem and an approach to its clinical care. I wish to thank all of the authors not only for their ability to distill from the literature and their experience the current state of our art, but also for continuing to define pediatric surgery as both an art and a science.