BOOK
Sabiston Textbook of Surgery E-Book
Courtney M. Townsend | R. Daniel Beauchamp | B. Mark Evers | Kenneth L. Mattox | Courtney M. Townsend | R. Daniel Beauchamp | B. Mark Evers | Kenneth L. Mattox
(2012)
Additional Information
Book Details
Abstract
Sabiston Textbook of Surgery is your ultimate foundation for confident surgical decision making. Covering the very latest science and data affecting your treatment planning, this esteemed medical reference helps you make the most informed choices so you can ensure the best outcome for every patient.
- Consult it on the go with online access at expertconsult.com, and get regular updates on timely new findings and advances.
- Overcome tough challenges, manage unusual situations, and avoid complications with the most trusted advice in your field.
- Prepare for tests and exams with review questions and answers online.
- Keep up with the very latest developments concerning abdominal wall reconstruction, tumor immunology and immunotherapy, peripheral vascular disease, regenerative medicine, liver transplantation, kidney and pancreas transplantation, small bowel transplantation, the continually expanding role of minimally invasive and robotic surgery, and many other rapidly evolving areas.
- Weigh your options by reviewing the most recent outcomes data and references to the most current literature.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Inside front cover | ifc | ||
| Sabiston Textbook of Surgery | i | ||
| Copyright page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| FOREWORD | xv | ||
| Preface | xvii | ||
| ACKNOWLEDGMENTS | xix | ||
| Table of contents | xxi | ||
| Video Contents | xxv | ||
| Section 1 Surgical Basic Principles | 1 | ||
| Chapter 1 History of Surgery | 2 | ||
| Importance of Understanding Surgical History | 2 | ||
| Historical Relationship Between Surgery and Medicine | 2 | ||
| Knowledge of Human Anatomy | 3 | ||
| Method of Controlling Hemorrhage | 3 | ||
| Pathophysiologic Basis of Surgical Diseases | 4 | ||
| Anesthesia | 4 | ||
| Antisepsis, Asepsis, and Understanding the Nature of Infection | 5 | ||
| X-Rays | 6 | ||
| Early 20th Century | 6 | ||
| Ascent of Scientific Surgery | 7 | ||
| Internationalization, Surgical Societies, and Journals | 8 | ||
| World War I | 8 | ||
| American College of Surgeons | 9 | ||
| Women Surgeons | 9 | ||
| African American Surgeons | 10 | ||
| Modern ERA | 11 | ||
| Last Half of the 20th Century | 12 | ||
| Cardiac Surgery and Organ Transplantation | 12 | ||
| Political and Socioeconomic Influences | 14 | ||
| 20th Century Surgical Highlights | 15 | ||
| Future Trends | 17 | ||
| Selected References | 17 | ||
| Chapter 2 Ethics and Professionalism in Surgery | 19 | ||
| The Importance of Ethics in Surgery | 19 | ||
| End-of-Life Care | 20 | ||
| Resuscitation in the Operating Room | 20 | ||
| Cultural Sensitivity | 20 | ||
| Shared Decision Making | 21 | ||
| Professionalism | 22 | ||
| Conclusion | 22 | ||
| Selected References | 22 | ||
| References | 22 | ||
| Chapter 3 Molecular and Cell Biology | 24 | ||
| Human Genome | 24 | ||
| Structure of Genes and DNA | 24 | ||
| DNA Replication and Repair | 25 | ||
| RNA and Protein Synthesis | 25 | ||
| Control of Gene Expression | 26 | ||
| Recombinant DNA Technology | 27 | ||
| Restriction Nucleases | 27 | ||
| Polymerase Chain Reaction | 28 | ||
| DNA Sequencing | 29 | ||
| DNA Cloning | 29 | ||
| DNA Engineering | 29 | ||
| Transgenic Animals | 30 | ||
| RNA Interference | 30 | ||
| Cell Signaling | 31 | ||
| Ligands and Receptors | 31 | ||
| G Protein–Coupled Receptors | 31 | ||
| Enzyme-Coupled Receptors | 32 | ||
| Cell Division Cycle | 32 | ||
| Regulation of the Cell Division Cycle by Cyclin, Cyclin-Dependent Kinase, and Cdk Inhibitory Proteins | 33 | ||
| Cell Cycle Checkpoints | 33 | ||
| Oncogenes and Tumor Suppressor Genes | 33 | ||
| Cell Death | 33 | ||
| Apoptosis | 33 | ||
| Autophagy | 34 | ||
| Human Genome Project | 35 | ||
| Transplantation | 35 | ||
| Oncology | 36 | ||
| Pediatric and Fetal Surgery | 36 | ||
| Proteomics | 36 | ||
| Novel Treatment Strategies | 36 | ||
| Gene Therapy | 36 | ||
| Short Interfering RNA | 37 | ||
| Drug Design | 37 | ||
| Genetic Engineering of Antibodies | 37 | ||
| Ethical, Psychological, and Legal Implications | 38 | ||
| Selected References | 38 | ||
| References | 38 | ||
| Chapter 4 The Inflammatory Response | 40 | ||
| The Danger Hypothesis: Danger-Associated Molecular Patterns, Pathogen-Associated Molecular Patterns, and Alarmins | 40 | ||
| Lipopolysaccharide | 41 | ||
| Toll-Like Receptors | 42 | ||
| Other Families of Pattern Recognition Receptors | 42 | ||
| High-Mobility Group Box 1 | 42 | ||
| Heat Shock Proteins | 44 | ||
| Cytokines and Chemokines | 44 | ||
| Interferon-γ and Granulocyte-Macrophage Colony-Stimulating Factor | 44 | ||
| Interleukin-1 and Tumor Necrosis Factor | 47 | ||
| Interleukin-1 and the Interleukin-1 Receptor | 48 | ||
| Tumor Necrosis Factor | 51 | ||
| Interleukin-1 and Tumor Necrosis Factor as Targets for Anti-Inflammatory Therapeutic Agents | 52 | ||
| Interleukin-6 and Interleukin-11 | 54 | ||
| Interleukin-8 and Other Chemokines | 54 | ||
| Interleukin-12 | 55 | ||
| Interleukin-17 and Related Cytokines | 55 | ||
| Interleukin-18 | 56 | ||
| Interleukin-4, Interleukin-10, and Interleukin-13 | 56 | ||
| Transforming Growth Factor-β | 57 | ||
| Macrophage Migration Inhibitory Factor | 58 | ||
| Complement | 58 | ||
| Eicosanoids: Thromboxane, Prostaglandins, and Leukotrienes | 60 | ||
| Nitric Oxide | 60 | ||
| Carbon Monoxide | 61 | ||
| Hydrogen Sulfide | 61 | ||
| Reactive Oxygen Species | 61 | ||
| Neuroendocrine Control of the Inflammatory Response | 62 | ||
| Corticosteroids | 62 | ||
| Catecholamines | 63 | ||
| Cholinergic Anti-Inflammatory Pathway | 63 | ||
| Selected References | 63 | ||
| References | 64 | ||
| Chapter 5 Shock, Electrolytes, and Fluid | 66 | ||
| History | 66 | ||
| Resuscitation | 66 | ||
| Shock | 67 | ||
| Fluids | 70 | ||
| Blood Transfusions | 71 | ||
| Physiology of Shock | 72 | ||
| Bleeding | 72 | ||
| Lactate and Base Deficit | 74 | ||
| Compensatory Mechanisms | 75 | ||
| Lethal Triad | 75 | ||
| Acidosis | 76 | ||
| Hypothermia | 76 | ||
| Coagulopathy | 78 | ||
| Oxygen Delivery | 79 | ||
| Optimization (Supernormalization) | 81 | ||
| Global Perfusion Versus Regional Perfusion | 82 | ||
| Septic Shock | 85 | ||
| Other Supportive Therapeutic Options for Severe Sepsis | 85 | ||
| Blood Product Administration | 85 | ||
| Mechanical Ventilation of Sepsis-Induced Acute Lung Injury or Acute Respiratory Distress Syndrome | 86 | ||
| Sedation, Analgesia, and Neuromuscular Blockade | 86 | ||
| Glucose Control | 86 | ||
| Renal Replacement | 86 | ||
| Bicarbonate Therapy | 86 | ||
| Deep Vein Thrombosis Prophylaxis | 86 | ||
| Stress Ulcer Prophylaxis | 86 | ||
| Consideration for Limitation of Support | 86 | ||
| Resuscitation | 87 | ||
| Problems With Resuscitation | 87 | ||
| Bleeding | 88 | ||
| Trauma Immunology and Inflammation | 89 | ||
| Evolution of Modern Resuscitation | 91 | ||
| Detrimental Impact of Fluids | 91 | ||
| Damage Control Resuscitation | 94 | ||
| Whole Blood Resuscitation | 94 | ||
| Resuscitation With 1 : 1 : 1 | 95 | ||
| Massive Transfusion Protocol | 95 | ||
| Current Status of Fluid Types | 97 | ||
| Crystalloids | 97 | ||
| Hypertonic Saline | 98 | ||
| Colloids | 100 | ||
| Future Resuscitation Research | 100 | ||
| Blood Substitutes | 100 | ||
| Perfluorocarbons | 102 | ||
| Novel Fluids | 102 | ||
| Freeze-Dried Plasma | 103 | ||
| Pharmacologic Agents | 103 | ||
| Suspended Animation | 104 | ||
| Perioperative Fluid Management | 104 | ||
| Body Water | 104 | ||
| Maintenance Fluids | 105 | ||
| Adrenal Gland | 108 | ||
| Antidiuretic Hormone and Water | 108 | ||
| Electrolytes | 109 | ||
| Sodium | 109 | ||
| Hyponatremia | 109 | ||
| Hypernatremia | 110 | ||
| Potassium | 110 | ||
| Hypokalemia | 110 | ||
| Treatment of Acute Hypokalemia | 111 | ||
| Hyperkalemia | 111 | ||
| Treatment of Hyperkalemia | 112 | ||
| Calcium | 112 | ||
| Hypocalcemia | 113 | ||
| Treatment of Hypocalcemia | 113 | ||
| Hypercalcemia | 114 | ||
| Treatment | 115 | ||
| Magnesium | 115 | ||
| Hypomagnesemia | 116 | ||
| Treatment | 116 | ||
| Hypermagnesemia | 116 | ||
| Treatment | 117 | ||
| Selected References | 117 | ||
| References | 118 | ||
| Chapter 6 Metabolism in Surgical Patients | 120 | ||
| Nutritional Requirements | 120 | ||
| Carbohydrate Metabolism | 122 | ||
| Lipid Metabolism | 123 | ||
| Protein Metabolism | 123 | ||
| Regulation of the Amino Acid Pool | 124 | ||
| Glucose-Alanine and Glucose-Lactate Amino Acid Cycles | 124 | ||
| Intestinal Health | 125 | ||
| Protein Turnover | 125 | ||
| Proteolysis | 125 | ||
| Vitamins and Micronutrients | 126 | ||
| Nutritional Assessment and Monitoring | 126 | ||
| Malnutrition and Starvation | 128 | ||
| Physical Body Measurements | 128 | ||
| Body Weight | 128 | ||
| Anthropometric Measurements | 128 | ||
| Ideal Body Weight | 128 | ||
| Body Mass Index | 128 | ||
| Interpretation of Body Mass Index | 128 | ||
| Evaluating Caloric Requirements | 129 | ||
| Energy Expenditure Equations | 129 | ||
| Harris-Benedict Equation | 129 | ||
| Indirect Calorimetry | 129 | ||
| Dual-Energy X-Ray Absorptiometry | 129 | ||
| Monitoring Nutritional Status | 129 | ||
| Nitrogen Balance | 130 | ||
| Pediatric Assessment | 130 | ||
| Serum Proteins | 130 | ||
| Nutritional Support | 130 | ||
| Initiating Nutritional Support | 132 | ||
| Principles Guiding Routes of Nutrition | 132 | ||
| Enteral Nutrition | 132 | ||
| Formulations | 135 | ||
| Complications | 135 | ||
| Parenteral Nutrition | 137 | ||
| Formulations | 138 | ||
| Ordering Parenteral Nutrition | 138 | ||
| Complications | 140 | ||
| Carbohydrate Content | 140 | ||
| Lipid Content | 141 | ||
| Protein Content | 141 | ||
| Fluid and Electrolytes | 141 | ||
| Special Considerations | 141 | ||
| Burn Injury and the Metabolic Stress Response | 141 | ||
| Immunonutrition | 143 | ||
| Omega-3 and Omega-6 Fatty Acids | 144 | ||
| Optimal Omega-6-to-Omega-3 Ratio in the Diet | 144 | ||
| Organ Transplantation | 144 | ||
| Inflammatory Bowel Disease | 144 | ||
| Short Bowel Syndrome | 144 | ||
| Malnutrition States | 145 | ||
| Marasmus | 145 | ||
| Kwashiorkor | 145 | ||
| Sepsis | 145 | ||
| Hepatic Insufficiency | 145 | ||
| Gastric Bypass Surgery | 146 | ||
| Intensive Insulin and Glycemic Control | 146 | ||
| Pancreatitis | 146 | ||
| Obesity | 146 | ||
| Comorbidities and Preexisting Conditions | 147 | ||
| Type 2 Diabetes Mellitus | 147 | ||
| Cardiovascular Disease | 147 | ||
| Deep Vein Thrombosis and Embolism | 147 | ||
| Hepatobiliary Disease | 147 | ||
| Osteoarthritis | 147 | ||
| Metabolic Syndrome | 148 | ||
| The Surgical Obese Patient | 148 | ||
| Summary | 148 | ||
| Selected References | 148 | ||
| References | 149 | ||
| Chapter 7 Wound Healing | 151 | ||
| Tissue Injury and Response | 151 | ||
| Wound-Healing Phases | 151 | ||
| Inflammatory Phase | 151 | ||
| Hemostasis and Inflammation | 151 | ||
| Increased Vascular Permeability | 151 | ||
| Chemokines | 152 | ||
| Polymorphonuclear Cells | 153 | ||
| Macrophages | 154 | ||
| Lymphocytes | 157 | ||
| Proliferative Phase | 158 | ||
| Angiogenesis | 158 | ||
| Fibroplasia | 159 | ||
| Epithelialization | 159 | ||
| Extracellular Matrix | 159 | ||
| Collagen Structure | 160 | ||
| Collagen Synthesis | 161 | ||
| Elastic Fibers | 161 | ||
| Glycosaminoglycans and Proteoglycans | 162 | ||
| Basal Lamina | 163 | ||
| Degradation of the Extracellular Matrix | 163 | ||
| Maturational Phase | 163 | ||
| Remodeling | 164 | ||
| Abnormal Wound Healing | 164 | ||
| Hypertrophic Scars and Keloids | 164 | ||
| Chronic Nonhealing Wounds | 165 | ||
| Infection | 167 | ||
| Other Causes of Abnormal Wound Healing | 167 | ||
| Hypoxia | 167 | ||
| Diabetes | 167 | ||
| Ionizing Radiation | 168 | ||
| Aging | 168 | ||
| Malnutrition | 168 | ||
| Drugs | 168 | ||
| Relationship Between Immunity and Wound Repair or Regeneration | 168 | ||
| Fetal Wound Healing | 168 | ||
| Wound Dressings | 170 | ||
| Other Therapies | 172 | ||
| Hyperbaric Oxygen | 172 | ||
| Negative Pressure–Assisted Wound Closure | 173 | ||
| New Horizons | 174 | ||
| Tissue Engineering | 174 | ||
| Scaffolds | 174 | ||
| Gene and Stem Cell Therapy | 174 | ||
| Selected References | 175 | ||
| References | 176 | ||
| Chapter 8 Regenerative Medicine | 178 | ||
| Stem Cell Sources | 178 | ||
| Embryonic Stem Cells | 178 | ||
| Somatic Cell Nuclear Transfer | 180 | ||
| Induced Pluripotent Stem Cells | 180 | ||
| Fetal Stem Cells | 180 | ||
| Adult Stem Cells | 181 | ||
| Tissue-Specific Stem Cells | 181 | ||
| Adult Multipotent Stem Cells | 181 | ||
| Hematopoietic Stem Cells | 181 | ||
| Mesenchymal Stem Cells | 181 | ||
| Adipose-Derived Stromal Cells | 182 | ||
| Endothelial Progenitor Cells | 183 | ||
| Stem Cells and Cancer | 183 | ||
| Bioengineering for Regenerative Medicine | 183 | ||
| Research Applications | 183 | ||
| Biomaterials as Constructs for Cell Delivery and Directed Differentiation | 183 | ||
| Organ-Level Tissue Engineering | 184 | ||
| Clinical Applications of Stem Cells | 184 | ||
| Embryonic Stem Cells | 184 | ||
| Fetal Stem Cells | 184 | ||
| Multipotent Adult Stem Cells | 184 | ||
| Selected References | 185 | ||
| References | 186 | ||
| Chapter 9 Evidence-Based Surgery: | 188 | ||
| What is the Purpose of the Study? | 188 | ||
| What is being Compared? | 188 | ||
| Misclassification | 188 | ||
| Time-Varying Exposures | 189 | ||
| What is the Outcome of Interest? | 190 | ||
| Safety | 190 | ||
| Effectiveness and Efficacy | 190 | ||
| Patient-Reported Outcomes | 190 | ||
| Resource Utilization | 190 | ||
| Costs | 191 | ||
| Surrogate End Points | 191 | ||
| What is the Study Design? | 192 | ||
| Randomized Controlled Trials | 192 | ||
| Meta-Analysis | 193 | ||
| Cohort Study | 193 | ||
| Case-Control | 193 | ||
| Case Reports and Case Series | 194 | ||
| What is the Source of Data? | 194 | ||
| Are there Nonanalytic Issues Worthy of Consideration? | 194 | ||
| Confounding | 194 | ||
| Generalizability | 194 | ||
| Determining Causality Using Observational Data | 195 | ||
| How were the Data Analyzed? | 195 | ||
| Variable Types and Descriptive Statistics | 195 | ||
| Hypothesis Testing | 195 | ||
| Multivariable Analysis | 196 | ||
| Propensity Score Analysis | 196 | ||
| Instrumental Variable Analysis | 196 | ||
| Missing Data | 197 | ||
| Correlated Data | 197 | ||
| Are there Ethical Considerations? | 197 | ||
| Conclusions | 198 | ||
| Selected References | 199 | ||
| References | 199 | ||
| Chapter 10 Perioperative Patient Safety | 201 | ||
| History and Perspective | 201 | ||
| Surgical Infection Prevention and Surgical Care Improvement Project | 201 | ||
| Use of Quality Data to Improve Outcomes of Surgical Patients | 202 | ||
| Effective Teams and Communication | 203 | ||
| Handoffs and Surgical Safety | 204 | ||
| Phases in Perioperative Care | 205 | ||
| Preoperative Phase | 205 | ||
| Intraoperative Phase | 205 | ||
| Postoperative Phase | 205 | ||
| Physician Fatigue and Surgical Safety | 205 | ||
| Use of Information Technology to Enhance Surgical Patient Safety | 206 | ||
| Computerized Order Entry | 206 | ||
| Other Applications for Information Technology in Surgical Patient Safety | 207 | ||
| Creating an Organizational Structure to Promote Patient Safety and Quality Care | 207 | ||
| Selected References | 207 | ||
| References | 208 | ||
| Section 2 Perioperative Management | 210 | ||
| Chapter 11 Principles of Preoperative and Operative Surgery | 211 | ||
| Preoperative Preparation of the Patient | 211 | ||
| Principles of, and Preparation for, Operative Surgery | 211 | ||
| Determining the Need for Surgery | 211 | ||
| Perioperative Decision Making | 211 | ||
| Preoperative Evaluation | 211 | ||
| Systems Approach to Preoperative Evaluation | 213 | ||
| Cardiovascular System | 213 | ||
| Pulmonary System | 216 | ||
| Renal System | 216 | ||
| Hepatobiliary System | 219 | ||
| Endocrine System | 221 | ||
| Perioperative Diabetic Management | 221 | ||
| Management of Other Endocrinopathies | 221 | ||
| Immune System | 222 | ||
| Human Immunodeficiency Virus–Infected Patients and Surgery | 223 | ||
| Hematologic System | 223 | ||
| Additional Preoperative Considerations | 225 | ||
| Age | 225 | ||
| Nutritional Status | 225 | ||
| Obesity | 226 | ||
| Preoperative Checklist | 226 | ||
| Antibiotic Prophylaxis | 226 | ||
| Review of Medications | 229 | ||
| Preoperative Fasting | 229 | ||
| Potential Causes of Intraoperative Instability | 230 | ||
| Myocardial Infarction | 230 | ||
| Pulmonary Embolism | 230 | ||
| Pneumothorax | 230 | ||
| Anaphylaxis and Latex Allergy | 230 | ||
| Malignant Hyperthermia | 230 | ||
| Wrong-Site Surgery and Universal Protocol | 231 | ||
| The Operating Room | 231 | ||
| Maintenance of Normothermia | 232 | ||
| Preoperative Skin Preparation | 232 | ||
| Hemostasis | 232 | ||
| Wound Closure | 233 | ||
| Staplers | 234 | ||
| Surgical Adhesives | 235 | ||
| Surgical Devices and Energy Sources | 235 | ||
| Electrosurgery and Electrocautery | 235 | ||
| Lasers | 235 | ||
| Argon Beam Coagulator | 236 | ||
| Photodynamic Therapy | 236 | ||
| High-Frequency Sound Wave Techniques | 236 | ||
| Harmonic Scalpel | 236 | ||
| Ultrasonic Cavitation Devices | 236 | ||
| Radiofrequency Ablation | 236 | ||
| Cryoablation | 237 | ||
| Microwave Ablation and Radiosurgery | 237 | ||
| Outpatient Surgery | 237 | ||
| Selected References | 238 | ||
| References | 238 | ||
| Chapter 12 Surgical Infections and Antibiotic Use | 240 | ||
| Risk Factors for Infection | 240 | ||
| Host Factors | 240 | ||
| Genetics and Genomics of Trauma and Sepsis | 240 | ||
| Interactions Between the Host and Therapy | 242 | ||
| Blood Transfusion | 242 | ||
| Control of Blood Sugar | 242 | ||
| Infection Control | 243 | ||
| Catheter Care | 243 | ||
| Specific Infections | 244 | ||
| Surgical Site Infection | 244 | ||
| Postoperative Pneumonia | 246 | ||
| Central Line–Associated Bloodstream Infection | 249 | ||
| Urinary Tract Infection | 249 | ||
| Intra-Abdominal Infection | 250 | ||
| Antibiotic Use | 250 | ||
| Pharmacokinetic and Pharmacodynamic Principles | 250 | ||
| Antibiotic Prophylaxis | 251 | ||
| Principles of Antibiotic Therapy | 252 | ||
| Evaluation of Possible Infection | 252 | ||
| Blood Cultures | 254 | ||
| Empirical Antibiotic Therapy | 254 | ||
| Choice of Antibiotic | 255 | ||
| Duration of Therapy | 255 | ||
| Disease-, Pathogen-, and Antibiotic-Specific Considerations | 256 | ||
| Pneumonia | 256 | ||
| Central Line–Associated Bloodstream Infection | 256 | ||
| Intra-Abdominal Infection | 256 | ||
| Clostridium difficile–Associated Disease | 257 | ||
| Complicated Skin and Soft Tissue Infections | 257 | ||
| Antibiotic Activity Spectra | 257 | ||
| Cell Wall Active Agents | 259 | ||
| β-Lactam Antibiotics | 259 | ||
| Penicillins | 259 | ||
| Cephalosporins | 259 | ||
| Monobactams | 259 | ||
| Carbapenems | 259 | ||
| Lipoglycopeptides | 260 | ||
| Cyclic Lipopeptides | 260 | ||
| Polymyxins | 260 | ||
| Protein Synthesis Inhibitors | 261 | ||
| Aminoglycosides | 261 | ||
| Tetracyclines | 261 | ||
| Oxazolidinones | 261 | ||
| Macrolide-Lincosamide-Streptogramin Family | 261 | ||
| Clindamycin | 261 | ||
| Drugs That Disrupt Nucleic Acids | 262 | ||
| Fluoroquinolones | 262 | ||
| Cytotoxic Antibiotics | 262 | ||
| Metronidazole | 262 | ||
| Trimethoprim-Sulfamethoxazole | 262 | ||
| Antibiotic Toxicities | 262 | ||
| β-Lactam Allergy | 262 | ||
| Red Man Syndrome | 262 | ||
| Nephrotoxicity | 263 | ||
| Ototoxicity | 263 | ||
| Avoiding Toxicity: Adjustment of Antibiotic Dosage | 263 | ||
| Hepatic Insufficiency | 263 | ||
| Renal Insufficiency | 263 | ||
| Important Pathogens of Critically Ill Patients | 264 | ||
| Vancomycin-Resistant Enterococci | 264 | ||
| Staphylococcus aureus | 264 | ||
| Pseudomonas aeruginosa | 264 | ||
| Multidrug-Resistant Enterobacteriaceae, Including Klebsiella Species | 264 | ||
| Stenotrophomonas maltophilia | 264 | ||
| Acinetobacter baumannii Complex | 264 | ||
| Fungal Infections | 265 | ||
| Risk Factors | 265 | ||
| Diabetes Mellitus | 265 | ||
| Neutropenia | 265 | ||
| Organ Transplantation and Immunosuppression | 265 | ||
| Malignant Disease | 266 | ||
| Central Venous Catheters | 266 | ||
| Prediction of Invasive Candida Infection | 266 | ||
| Intensive Care Unit and Invasive Mechanical Ventilation | 266 | ||
| Fungal Pathogens | 266 | ||
| Candida albicans | 266 | ||
| Non–albicans Candida | 268 | ||
| Aspergillus | 268 | ||
| Other Emerging Fungal Pathogens | 268 | ||
| Prophylaxis | 268 | ||
| Antifungal Prophylaxis of Solid Organ Transplant Recipients | 268 | ||
| Antifungal Therapy | 269 | ||
| References | 271 | ||
| Chapter 13 Surgical Complications | 281 | ||
| Surgical Wound Complications | 281 | ||
| Seroma | 281 | ||
| Causes | 281 | ||
| Section 3 Trauma and Critical Care | 429 | ||
| Chapter 18 Management of Acute Trauma | 430 | ||
| Overview and History | 430 | ||
| Trauma Systems | 431 | ||
| Injury Scoring | 432 | ||
| Prehospital Trauma Care | 433 | ||
| Initial Assessment and Management | 435 | ||
| Airway | 435 | ||
| Breathing | 437 | ||
| Circulation | 437 | ||
| Disability and Exposure | 438 | ||
| Resuscitative Thoracotomy | 438 | ||
| Secondary Survey | 438 | ||
| Management of Specific Injuries | 438 | ||
| Damage Control Principles | 438 | ||
| Injuries to the Brain | 439 | ||
| Mechanism and Pathophysiology | 439 | ||
| Immediate Management | 440 | ||
| Evaluation | 440 | ||
| Management | 441 | ||
| Injuries to the Spinal Cord and Vertebral Column | 441 | ||
| Immediate Management | 441 | ||
| Evaluation | 442 | ||
| Management | 443 | ||
| Injury to the Maxillofacial Region | 444 | ||
| Immediate Management | 444 | ||
| Evaluation | 444 | ||
| Management | 444 | ||
| Injuries to the Neck | 445 | ||
| Immediate Management | 445 | ||
| Evaluation | 445 | ||
| Management | 446 | ||
| Injuries to the Chest | 447 | ||
| Immediate Management | 448 | ||
| Evaluation | 449 | ||
| Management | 449 | ||
| Chest Wall and Pleural Space Injuries | 449 | ||
| Pulmonary Injuries | 451 | ||
| Cardiac Injuries | 451 | ||
| Thoracic Aortic Injuries | 452 | ||
| Tracheobronchial Injuries | 453 | ||
| Esophageal Injuries | 453 | ||
| Diaphragmatic Injuries | 454 | ||
| Injuries to the Abdomen | 455 | ||
| Immediate Management | 455 | ||
| Blunt Abdominal Trauma Evaluation | 455 | ||
| Penetrating Abdominal Trauma Evaluation | 456 | ||
| Management | 457 | ||
| Splenic Injuries | 457 | ||
| Hepatic Injuries | 459 | ||
| Gastric Injuries | 461 | ||
| Duodenal Injuries | 462 | ||
| Pancreatic Injuries | 462 | ||
| Small Bowel Injuries | 463 | ||
| Colon Injuries | 465 | ||
| Abdominal Great Vessel Injuries | 466 | ||
| Genitourinary Injuries | 467 | ||
| Injuries to the Pelvis and Lower Extremities | 467 | ||
| Rehabilitation | 467 | ||
| Selected References | 468 | ||
| References | 469 | ||
| Chapter 19 The Difficult Abdominal Wall | 471 | ||
| Acute Presentation | 471 | ||
| Definitions and Management | 471 | ||
| Intra-Abdominal Hypertension or Abdominal Compartment Syndrome Complicating the Difficult Abdominal Wall | 471 | ||
| Abdominal Catastrophe Complicating the Difficult Abdominal Wall | 473 | ||
| Other Conditions Complicating the Difficult Abdominal Wall | 473 | ||
| Temporary Abdominal Closure | 473 | ||
| Techniques | 473 | ||
| Assessing Readiness for Abdominal Closure | 474 | ||
| Abdominal Closure or Planned Ventral Hernia? | 474 | ||
| Elective Planned Ventral Hernia Repair | 475 | ||
| Dynamic Abdominal Wall Reconstruction | 475 | ||
| Component Separation | 475 | ||
| Summary | 476 | ||
| Selected References | 477 | ||
| References | 478 | ||
| Chapter 20 Emergency Care of Musculoskeletal Injuries | 480 | ||
| Epidemiology of Orthopedic Injuries | 480 | ||
| Terminology | 480 | ||
| Fracture Types | 480 | ||
| Other Injuries | 483 | ||
| Fixation Principles | 483 | ||
| External Fixation | 483 | ||
| Internal Fixation | 485 | ||
| Pins and Screws | 485 | ||
| Plates | 486 | ||
| Tension Bands | 486 | ||
| Intramedullary Nails | 486 | ||
| Patient Evaluation | 487 | ||
| History | 487 | ||
| Trauma Room Evaluation | 490 | ||
| Diagnostic Imaging | 491 | ||
| Shoulder | 491 | ||
| Elbow | 491 | ||
| Pelvis and Acetabulum | 492 | ||
| Hip | 493 | ||
| Knee | 493 | ||
| Ankle | 493 | ||
| Foot | 494 | ||
| Spine | 495 | ||
| Intra-Articular Fractures | 495 | ||
| Stress Radiographs | 495 | ||
| Vascular Injuries | 495 | ||
| Initial Management | 496 | ||
| Wound Management | 496 | ||
| Reduction and Immobilization | 496 | ||
| Traction | 496 | ||
| Prioritization of Surgical Care | 498 | ||
| Orthopedic Emergencies | 499 | ||
| Open Fractures | 499 | ||
| Classification | 499 | ||
| Initial Management | 500 | ||
| Limb Salvage Versus Primary Amputation | 500 | ||
| Skeletal Stabilization | 501 | ||
| Acute Compartment Syndrome | 502 | ||
| Pathogenesis | 502 | ||
| Diagnosis | 502 | ||
| Tissue Pressure Measurements | 503 | ||
| Surgical Treatment | 503 | ||
| Pelvic Ring Disruption | 504 | ||
| Classification | 504 | ||
| Hemorrhage in Pelvic Fracture | 507 | ||
| Stabilization | 507 | ||
| Management | 509 | ||
| Spinal Injuries | 509 | ||
| Dislocations | 510 | ||
| Patient Evaluation | 510 | ||
| Treatment | 512 | ||
| Vascular Injuries | 512 | ||
| Incidence | 512 | ||
| Management | 513 | ||
| Common Long Bone Fractures | 513 | ||
| Femur Fractures | 513 | ||
| Epidemiology and Significance | 513 | ||
| Initial Management | 513 | ||
| Definitive Stabilization | 513 | ||
| Tibial Shaft Fractures | 514 | ||
| Epidemiology and Significance | 514 | ||
| Blood Supply | 514 | ||
| Associated Soft Tissue Injuries | 514 | ||
| Management and Treatment | 514 | ||
| Humeral Shaft Fractures | 515 | ||
| Epidemiology and Significance | 515 | ||
| Treatment | 515 | ||
| Challenges and Complications | 515 | ||
| Missed Injuries | 515 | ||
| Drug and Alcohol Use | 515 | ||
| Thromboembolic Complications | 516 | ||
| Pulmonary Failure: Fat Emboli Syndrome and Adult Respiratory Distress Syndrome | 517 | ||
| Postoperative Mobilization | 517 | ||
| Summary | 518 | ||
| Selected References | 518 | ||
| References | 519 | ||
| Chapter 21 Burns | 521 | ||
| Causes | 521 | ||
| Pathophysiology of Burn Injuries | 521 | ||
| Local Changes | 521 | ||
| Burn Depth | 522 | ||
| Burn Size | 523 | ||
| Systemic Changes | 523 | ||
| Hypermetabolic Response to Burn Injury | 524 | ||
| Inflammation and Edema | 526 | ||
| Effects on the Cardiovascular System | 527 | ||
| Effects on the Renal System | 527 | ||
| Effects on the Gastrointestinal System | 528 | ||
| Effects on the Immune System | 528 | ||
| Management | 529 | ||
| Basic Treatment | 529 | ||
| Prehospital Management | 529 | ||
| Initial Assessment | 529 | ||
| Initial Wound Care | 529 | ||
| Transport | 529 | ||
| Resuscitation | 529 | ||
| Escharotomies | 531 | ||
| Specific Treatment | 531 | ||
| Inhalation Injury | 531 | ||
| Wound Care | 532 | ||
| Antimicrobials | 532 | ||
| Topical Antibiotics | 533 | ||
| Systemic Antimicrobials | 534 | ||
| Burn Wound Excision | 534 | ||
| Tangential Excision | 534 | ||
| Full-Thickness Excision | 534 | ||
| Fascial Excision | 534 | ||
| Burn Wound Coverage | 534 | ||
| Multiorgan Failure | 535 | ||
| Causative Factors and Pathophysiology | 535 | ||
| Prevention | 536 | ||
| Organ Failure | 536 | ||
| Renal Failure | 536 | ||
| Pulmonary Failure | 537 | ||
| Hepatic Failure | 537 | ||
| Hematologic Failure | 537 | ||
| Central Nervous System Failure | 537 | ||
| Attenuation of the Hypermetabolic Response | 537 | ||
| Nonpharmacologic Modalities | 537 | ||
| Nutritional Support | 537 | ||
| Environmental Support | 538 | ||
| Exercise and Adjunctive Measures | 538 | ||
| Pharmacologic Modalities | 539 | ||
| Recombinant Human Growth Hormone | 539 | ||
| Insulin-Like Growth Factor | 539 | ||
| Oxandrolone | 540 | ||
| Propranolol | 540 | ||
| Attenuation of Postburn Hyperglycemia | 541 | ||
| Insulin | 541 | ||
| Metformin | 542 | ||
| Novel Therapeutic Options | 542 | ||
| Special Considerations: Electrical and Chemical Burns | 542 | ||
| Electrical Burns | 542 | ||
| Initial Treatment | 542 | ||
| Delayed Effects | 543 | ||
| Chemical Burns | 543 | ||
| Alkali | 543 | ||
| Acids | 543 | ||
| Hydrocarbons | 544 | ||
| Outcomes | 544 | ||
| Burn Units | 545 | ||
| Summary | 545 | ||
| Selected References | 546 | ||
| References | 546 | ||
| Chapter 22 Bites and Stings | 548 | ||
| Snakebites | 548 | ||
| Epidemiology | 548 | ||
| Species | 548 | ||
| Toxicology | 548 | ||
| Clinical Manifestations | 548 | ||
| Local | 548 | ||
| Systemic | 548 | ||
| Management | 549 | ||
| Field Treatment | 549 | ||
| Hospital Management | 549 | ||
| Antivenom Therapy | 550 | ||
| Wound Care and Blood Products | 550 | ||
| Fasciotomy | 551 | ||
| Mammalian Bites | 551 | ||
| Epidemiology | 551 | ||
| Treatment | 551 | ||
| Evaluation | 551 | ||
| Wound Care | 551 | ||
| Microbiology | 552 | ||
| Antibiotics | 553 | ||
| Rabies | 553 | ||
| Arthropod Bites and Stings | 553 | ||
| Black Widow Spiders | 553 | ||
| Section 4 Transplantation and Immunology | 616 | ||
| Chapter 26 Transplantation Immunobiology and Immunosuppression | 617 | ||
| The Immune Response | 617 | ||
| Acquired Immunity | 617 | ||
| Major Histocompatibility Locus: Transplantation Antigens | 618 | ||
| Human Histocompatibility Complex | 619 | ||
| Class I Major Histocompatibility Complex | 620 | ||
| Class II MHC | 621 | ||
| HLA Typing: Implications for Transplantation | 621 | ||
| Cellular Components of the Acquired Immune System | 622 | ||
| T Cells | 622 | ||
| T Cell Receptor | 622 | ||
| T Cell Activation | 627 | ||
| Costimulation | 627 | ||
| T Cell Effector Functions | 629 | ||
| B Cells | 632 | ||
| B Cell Receptor and Antibody | 632 | ||
| B Cell Activation | 632 | ||
| Innate Immunity | 634 | ||
| Monocytes | 634 | ||
| Dendritic Cells | 635 | ||
| Natural Killer Cells | 635 | ||
| Cytokines | 635 | ||
| Transplantation Immunity | 636 | ||
| Rejection | 637 | ||
| Hyperacute Rejection | 637 | ||
| Acute Rejection | 637 | ||
| Chronic Rejection | 641 | ||
| Immunosuppression | 641 | ||
| Corticosteroids | 641 | ||
| Antiproliferative Agents | 642 | ||
| Azathioprine | 642 | ||
| Mycophenolate Mofetil | 643 | ||
| Calcineurin Inhibitors | 643 | ||
| Cyclosporine | 643 | ||
| Tacrolimus | 643 | ||
| Lymphocyte Depletion Preparations | 644 | ||
| Antilymphocyte Globulin | 644 | ||
| Muromonab-CD3 | 645 | ||
| Anti–Interleukin-2 Receptor Antibodies | 645 | ||
| Other Immunoglobulin Therapies | 646 | ||
| Rituximab | 646 | ||
| Alemtuzumab | 646 | ||
| Intravenous Immunoglobulin | 646 | ||
| Newer Immunosuppressive Agents | 646 | ||
| Mammalian Target of Rapamycin Inhibitors | 646 | ||
| Beletacept | 646 | ||
| Fingolimod | 647 | ||
| Deoxyspergualin | 647 | ||
| Complications of Immunosuppression | 647 | ||
| Risk of Infection | 647 | ||
| Risk for Malignancy | 648 | ||
| Nonimmune Side Effects | 648 | ||
| Tolerance | 648 | ||
| T Cell Ablation | 649 | ||
| Costimulation Blockade | 649 | ||
| Mixed Chimerism | 649 | ||
| Xenotransplantation | 650 | ||
| Concordant Xenografts | 650 | ||
| Discordant Xenografts | 650 | ||
| New Areas of Transplantation | 651 | ||
| Islet Cell Transplantation | 651 | ||
| Composite Tissue Transplantation | 651 | ||
| Conclusion | 651 | ||
| Selected References | 653 | ||
| References | 653 | ||
| Chapter 27 Liver Transplantation | 655 | ||
| History | 655 | ||
| Indications and Contraindications | 655 | ||
| Indications | 655 | ||
| Fulminant Hepatic Failure | 656 | ||
| Hepatitis C and Liver Transplantation | 656 | ||
| Hepatitis B | 656 | ||
| Primary Biliary Cirrhosis | 657 | ||
| Primary Sclerosing Cholangitis | 657 | ||
| Alcoholic Liver Disease | 657 | ||
| Nonalcoholic Steatohepatitis | 657 | ||
| Biliary Atresia | 657 | ||
| Contraindications | 657 | ||
| Organ Shortage, Model for End-Stage Liver Disease, and Liver Distribution | 658 | ||
| Model for End-Stage Liver Disease Formula | 658 | ||
| Live Donor Liver Transplantation | 658 | ||
| Technical Aspects of Liver Transplantation | 659 | ||
| Split Liver Transplant | 660 | ||
| Live Donor Operation | 660 | ||
| Segment 2-3 Hepatectomy | 660 | ||
| Right Lobe Dissection for Live Donor Liver Transplantation | 661 | ||
| Left Lobe Dissection for Live Donor Liver Transplantation | 661 | ||
| Implantation of Partial Liver Graft | 661 | ||
| Early Complications of Liver Transplantation | 661 | ||
| Outcome | 662 | ||
| Extended Criteria Donors | 662 | ||
| Evaluation of Abnormal Liver Function Test Results | 662 | ||
| Immunosuppression after Liver Transplantation | 662 | ||
| Retransplantation and Recurrent Disease | 663 | ||
| Role of Liver Transplantation for Hepatocellular Carcinoma | 663 | ||
| Role of Cellular Transplantation in Liver Replacement | 663 | ||
| Selected References | 664 | ||
| References | 664 | ||
| Chapter 28 Kidney and Pancreas Transplantation | 666 | ||
| Historical Perspective | 666 | ||
| Kidney Transplantation | 666 | ||
| Indications | 666 | ||
| Patient Selection | 666 | ||
| Living Donor Selection | 668 | ||
| Laparoscopic Surgical Technique | 669 | ||
| Open Surgical Technique | 669 | ||
| Postoperative Care and Follow-Up | 670 | ||
| Deceased Donors | 670 | ||
| Kidney Procurement and Preparation | 670 | ||
| Preservation and Storage | 672 | ||
| Recipient Operation | 672 | ||
| Postoperative Surgical Complications | 672 | ||
| Hemorrhage | 672 | ||
| Venous Thrombosis | 672 | ||
| Arterial Thrombosis | 673 | ||
| Arterial Stenosis | 673 | ||
| Urologic Complications | 673 | ||
| Lymphocele | 674 | ||
| Infections | 674 | ||
| Outcomes | 674 | ||
| Pancreas Transplantation | 675 | ||
| Patient Selection | 675 | ||
| Pancreas Donor | 675 | ||
| Pancreas Procurement, Preparation, and Transplantation | 676 | ||
| Drainage Techniques: Endocrine and Exocrine Secretions | 677 | ||
| Bladder Drainage or Enteric Drainage | 677 | ||
| Systemic Drainage Versus Portal Drainage | 677 | ||
| Surgical Complications | 677 | ||
| Leak | 677 | ||
| Vascular Complications | 677 | ||
| Thrombosis | 677 | ||
| Bleeding | 678 | ||
| Other Considerations | 678 | ||
| Infection | 678 | ||
| Pancreatitis | 678 | ||
| Bowel Obstruction | 678 | ||
| Section 5 Surgical Oncology | 691 | ||
| Chapter 30 Tumor Biology and Tumor Markers | 692 | ||
| Epidemiology | 692 | ||
| Global Burden of Cancer | 692 | ||
| Aging and Cancer | 692 | ||
| Obesity and Cancer | 693 | ||
| Tumor Biology | 693 | ||
| Self-Sufficiency in Growth Signals | 695 | ||
| Insensitivity to Antigrowth Signals | 696 | ||
| Evasion of Cell Death | 698 | ||
| Limitless Replication Potential | 699 | ||
| Sustained Angiogenesis | 699 | ||
| Tissue Invasion and Metastasis | 700 | ||
| Outgrowth at Preferred Sites | 701 | ||
| Immunosurveillance and Immunoediting | 702 | ||
| Immunosurveillance | 702 | ||
| Immunoediting | 702 | ||
| Carcinogenesis | 703 | ||
| Cancer Genetics | 703 | ||
| Familial Cancer Syndromes | 704 | ||
| Retinoblastoma | 704 | ||
| Li-Fraumeni Syndrome | 705 | ||
| Familial Adenomatous Polyposis | 706 | ||
| Hereditary Nonpolyposis Colorectal Cancer | 707 | ||
| BRCA1 and BRCA2 | 707 | ||
| Multiple Endocrine Neoplasia | 707 | ||
| Type 1 | 707 | ||
| Type 2 | 708 | ||
| Von Hippel-Lindau Syndrome | 708 | ||
| Cancer Epigenetics | 708 | ||
| Carcinogens | 708 | ||
| Chemical Agents | 708 | ||
| Radiation Carcinogens | 710 | ||
| Infectious Carcinogens | 710 | ||
| Viral Carcinogenesis | 710 | ||
| Principles of Viral Carcinogenesis | 711 | ||
| Small DNA Tumor Viruses | 711 | ||
| Hepatitis B Virus | 711 | ||
| RNA Viruses: Human T Cell Lymphotropic Virus Type 1 and Hepatitis C Virus | 712 | ||
| Hepatitis C Virus | 712 | ||
| Helicobacter pylori | 712 | ||
| Chronic Inflammation | 712 | ||
| Tumor Markers | 712 | ||
| Protein Tumor Markers | 713 | ||
| Carcinoembryonic Antigen | 713 | ||
| Section 6 Head and Neck | 792 | ||
| Chapter 35 Head and Neck | 793 | ||
| Normal Histology | 793 | ||
| Epidemiology | 793 | ||
| Carcinogenesis | 794 | ||
| Staging | 795 | ||
| Clinical Overview | 796 | ||
| Evaluation | 796 | ||
| Positron Emission Tomography | 796 | ||
| Lymphatic Spread | 796 | ||
| Therapeutic Options | 797 | ||
| Anatomic Sites | 798 | ||
| Lip | 798 | ||
| Oral Cavity | 799 | ||
| Oral Tongue | 800 | ||
| Floor of the Mouth | 800 | ||
| Alveolus | 800 | ||
| Buccal Mucosa | 801 | ||
| Palate | 801 | ||
| Oropharynx | 801 | ||
| Hypopharynx | 802 | ||
| Larynx | 802 | ||
| Nasal Cavity and Paranasal Sinuses | 807 | ||
| Nasopharynx | 808 | ||
| Pituitary Surgery | 810 | ||
| Ear and Temporal Bone | 810 | ||
| Salivary Gland Neoplasms | 811 | ||
| Neck and Unknown Primary | 813 | ||
| Tracheotomy | 815 | ||
| Vocal Cord Paralysis | 816 | ||
| Reconstruction | 817 | ||
| Selected References | 821 | ||
| References | 821 | ||
| Section 7 Breast | 823 | ||
| Chapter 36 Diseases of the Breast | 824 | ||
| Anatomy | 824 | ||
| Microscopic Anatomy | 826 | ||
| Breast Development And Physiology | 827 | ||
| Normal Development and Physiology | 827 | ||
| Fibrocystic Changes and Breast Pain | 827 | ||
| Abnormal Development and Physiology | 828 | ||
| Absent or Accessory Breast Tissue | 828 | ||
| Gynecomastia | 828 | ||
| Nipple Discharge | 828 | ||
| Galactocele | 828 | ||
| Diagnosis Of Breast Disease | 828 | ||
| Patient History | 828 | ||
| Physical Examination | 829 | ||
| Biopsy | 830 | ||
| Fine-Needle Aspiration Biopsy | 830 | ||
| Core Needle Biopsy | 830 | ||
| Interpretation of Core Needle Biopsy Results | 831 | ||
| Breast Imaging | 831 | ||
| Screening Mammography | 831 | ||
| Ultrasonography | 832 | ||
| Magnetic Resonance Imaging | 832 | ||
| Nonpalpable Mammographic Abnormalities | 832 | ||
| Wire-Localized Surgical Excision | 833 | ||
| Identification And Management Of High-Risk Patients | 834 | ||
| Identification of High-Risk Patients | 834 | ||
| Risk Factors for Breast Cancer | 834 | ||
| Age and Gender | 834 | ||
| Personal History of Breast Cancer | 834 | ||
| Histologic Risk Factors | 834 | ||
| Family History and Genetic Risk Factors | 835 | ||
| Reproductive Risk Factors | 836 | ||
| Exogenous Hormone Use | 836 | ||
| Risk Assessment Tools | 836 | ||
| Management of High-Risk Patients | 837 | ||
| Close Surveillance | 837 | ||
| Chemoprevention for Breast Cancer | 837 | ||
| Prophylactic Mastectomy | 838 | ||
| Summary: Risk Assessment and Management | 838 | ||
| Benign Breast Tumors And Related Diseases | 838 | ||
| Breast Cysts | 838 | ||
| Fibroadenoma and Other Benign Tumors | 839 | ||
| Hamartoma and Adenoma | 839 | ||
| Breast Abscess and Infections | 839 | ||
| Papillomas and Papillomatosis | 840 | ||
| Sclerosing Adenosis | 840 | ||
| Radial Scar | 840 | ||
| Fat Necrosis | 840 | ||
| Epidemiology And Pathology Of Breast Cancer | 840 | ||
| Epidemiology | 840 | ||
| Pathology | 840 | ||
| Noninvasive Breast Cancer | 840 | ||
| Invasive Breast Cancer | 842 | ||
| Molecular Markers and Breast Cancer Subtypes | 842 | ||
| Other Tumors of the Breast | 845 | ||
| Phyllodes Tumors | 845 | ||
| Angiosarcoma | 845 | ||
| Staging Of Breast Cancer | 846 | ||
| Surgical Treatment Of Breast Cancer | 846 | ||
| Historical Perspective | 846 | ||
| Initial Surgical Trials of Local Therapy for Operable Breast Cancer | 846 | ||
| Radical Mastectomy Versus Total Mastectomy, With or Without Radiation Therapy | 846 | ||
| Clinical Trials Comparing Breast-Conserving Therapy With Mastectomy | 848 | ||
| NSABP B-06: Mastectomy Versus Lumpectomy With Irradiation Versus Lumpectomy Alone | 848 | ||
| Milan I Trial | 849 | ||
| Other Trials of Breast Conservation | 849 | ||
| Planning Surgical Treatments | 849 | ||
| Selection of Surgical Therapy | 850 | ||
| Eligibility for Breast Conservation | 850 | ||
| Tumor Size | 851 | ||
| Margins | 851 | ||
| Histology | 851 | ||
| Patient Age | 851 | ||
| Surgical Procedures for Breast Cancer | 851 | ||
| Breast-Conserving Surgery | 851 | ||
| Technical Aspects | 851 | ||
| Cosmetic Challenges | 852 | ||
| Extent of Breast Resection | 852 | ||
| Breast Size and Body Habitus | 852 | ||
| Tumor Location | 852 | ||
| Timing of Oncoplastic Surgery | 852 | ||
| Mastectomy | 852 | ||
| Indications | 852 | ||
| Breast Reconstruction | 852 | ||
| Technical Details | 852 | ||
| Simple and Modified Radical Mastectomy | 852 | ||
| Lymph Node Staging | 853 | ||
| Sentinel Node Technique | 854 | ||
| Treatment Of Ductal Carcinoma In Situ (Intraductal Carcinoma) | 855 | ||
| Mastectomy | 855 | ||
| Breast Conservation Therapy | 856 | ||
| Role of Tamoxifen | 857 | ||
| Sentinel Node Biopsy | 858 | ||
| Radiation Therapy For Breast Cancer | 858 | ||
| After Breast-Conserving Surgery | 858 | ||
| Postmastectomy Radiation Therapy | 858 | ||
| Systemic Therapy For Breast Cancer | 859 | ||
| Goals of Therapy and Determination of Risk of Harm | 859 | ||
| Chemotherapy | 860 | ||
| Trastuzumab-Based Chemotherapy Regimens | 862 | ||
| Endocrine Therapy | 862 | ||
| Tamoxifen | 862 | ||
| Ovarian Ablation | 863 | ||
| Aromatase Inhibitors | 863 | ||
| Summary of Medical Therapy for Early-Stage Breast Cancer | 863 | ||
| Neoadjuvant Systemic Therapy for Operable Breast Cancer | 863 | ||
| Treatment Of Locally Advanced And Inflammatory Breast Cancer | 864 | ||
| Treatment Of Special Conditions | 865 | ||
| Breast Cancer in Older Adults | 865 | ||
| Paget’s Disease | 865 | ||
| Male Breast Cancer | 865 | ||
| Interpreting Results Of Clinical Trials | 866 | ||
| Selected References | 867 | ||
| References | 867 | ||
| Chapter 37 Breast Reconstruction | 870 | ||
| Role of the General Surgeon in Breast Reconstruction | 870 | ||
| History | 870 | ||
| Patient Selection | 871 | ||
| Timing | 871 | ||
| Procedure Selection and Surgical Planning | 871 | ||
| Implant-Based Reconstructions | 872 | ||
| Combination Reconstruction | 873 | ||
| Autologous Reconstruction | 875 | ||
| Pedicled Flap | 875 | ||
| Abdominal-Based, Gluteal-Based, and Inner Thigh–Based Flaps | 875 | ||
| Abdominal-Based Flaps | 875 | ||
| Gluteal-Based Flaps | 877 | ||
| Inner Thigh–Based Flaps | 877 | ||
| Oncoplastic Surgery | 878 | ||
| Complications | 879 | ||
| Nipple-Areolar Reconstruction | 882 | ||
| Management of the Contralateral Breast | 882 | ||
| Surveillance | 882 | ||
| Conclusions | 882 | ||
| Selected References | 883 | ||
| References | 883 | ||
| Section 8 Endocrine | 885 | ||
| Chapter 38 Thyroid | 886 | ||
| Historical Perspective | 886 | ||
| Anatomy | 886 | ||
| Embryology | 886 | ||
| Adult Surgical Anatomy | 886 | ||
| Laryngeal Nerves | 887 | ||
| Recurrent Laryngeal Nerve | 887 | ||
| Superior Laryngeal Nerve | 888 | ||
| Blood Supply | 888 | ||
| Lymphatic System | 888 | ||
| Parathyroid Glands | 889 | ||
| Physiology of the Thyroid Gland | 889 | ||
| Iodine Metabolism | 889 | ||
| Thyroid Hormone Synthesis | 890 | ||
| Thyroglobulin | 891 | ||
| Calcitonin | 891 | ||
| Regulation of Thyroid Hormone Secretion | 891 | ||
| Peripheral Action of Thyroid Hormones | 892 | ||
| Inhibition of Thyroid Synthesis | 893 | ||
| Drugs | 893 | ||
| Iodine | 893 | ||
| Tests of Thyroid Function | 893 | ||
| Evaluation of the Pituitary-Thyroid Feedback Loop | 893 | ||
| Serum Triiodothyronine and Thyroxine Levels | 893 | ||
| Calcitonin | 893 | ||
| Radioactive Iodine Uptake | 893 | ||
| Thyroid Autoantibody Levels | 894 | ||
| Disorders of Thyroid Metabolism— Benign Thyroid Disease | 894 | ||
| Hypothyroidism | 894 | ||
| Metabolic Consequences of Iodine Deficiency | 894 | ||
| Postradiation Hypothyroidism | 894 | ||
| Postsurgical Hypothyroidism | 894 | ||
| Pharmacologic Hypothyroidism | 895 | ||
| Antithyroid Drugs | 895 | ||
| Amiodarone, Lithium, Cytokines | 895 | ||
| Diagnosis | 895 | ||
| Treatment | 895 | ||
| Thyroiditis | 895 | ||
| Hashimoto’s Thyroiditis | 895 | ||
| Acute Suppurative Thyroiditis | 895 | ||
| Subacute Thyroiditis | 895 | ||
| Riedel’s Struma | 896 | ||
| Hyperthyroidism | 896 | ||
| Hyperthyroid Disorders | 896 | ||
| Graves’ Disease | 896 | ||
| Toxic Nodular Goiter and Toxic Adenoma | 896 | ||
| Diagnosis | 897 | ||
| Treatment | 897 | ||
| Nonfunctioning Goiter | 898 | ||
| Multinodular Goiter | 898 | ||
| Substernal Goiter | 898 | ||
| Special Considerations for Patients With Goiter | 898 | ||
| Workup and Diagnosis of a Solitary Thyroid Nodule | 899 | ||
| Incidence | 899 | ||
| Initial Evaluation | 899 | ||
| Laboratory Evaluation | 900 | ||
| Thyroid Imaging | 900 | ||
| Ultrasound | 900 | ||
| Radioisotope Scanning | 901 | ||
| Computed Tomography and Magnetic Resonance Imaging | 901 | ||
| Fine-Needle Aspiration Biopsy | 901 | ||
| Decision Making and Treatment | 902 | ||
| Thyroid Malignancies | 904 | ||
| Thyroid Oncogenesis | 904 | ||
| Genetic Alterations | 904 | ||
| Ionizing Radiation | 906 | ||
| Papillary Carcinoma | 906 | ||
| Pathologic Classification | 906 | ||
| Clinical Features | 906 | ||
| Treatment | 907 | ||
| Follicular Carcinoma | 909 | ||
| Pathologic Classification | 910 | ||
| Clinical Features | 910 | ||
| Treatment | 911 | ||
| Postoperative Treatment | 911 | ||
| Hürthle Cell Carcinoma | 912 | ||
| Prognosis and Treatment | 912 | ||
| Medullary Carcinoma | 912 | ||
| Clinical Features | 912 | ||
| Section 9 Esophagus | 1011 | ||
| Chapter 43 Esophagus | 1012 | ||
| History | 1012 | ||
| Embryology | 1013 | ||
| Formation of the Gut Tube | 1013 | ||
| Molecular Regulation of the Gut Tube | 1013 | ||
| Differentiation of the Endoderm | 1013 | ||
| Muscular Development from the Mesoderm | 1014 | ||
| Anatomy | 1014 | ||
| Esophageal Inlet | 1014 | ||
| Esophageal Layers | 1015 | ||
| Anatomic Narrowing | 1015 | ||
| Gastroesophageal Junction | 1016 | ||
| Vasculature | 1016 | ||
| Lymphatics | 1016 | ||
| Innervation | 1016 | ||
| Physiology | 1017 | ||
| Swallowing | 1018 | ||
| Esophageal Phase | 1018 | ||
| Upper Esophageal Sphincter | 1018 | ||
| Peristalsis | 1019 | ||
| Lower Esophageal Sphincter | 1019 | ||
| Reflux Mechanism | 1021 | ||
| Neuromuscular Disorders of the Esophagus | 1023 | ||
| Diverticula | 1023 | ||
| Pharyngoesophageal (Zenker’s) Diverticulum | 1023 | ||
| Symptoms and Diagnosis | 1023 | ||
| Section 10 Abdomen | 1087 | ||
| Chapter 45 Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum, and Retroperitoneum | 1088 | ||
| Abdominal Wall And Umbilicus | 1088 | ||
| Embryology | 1088 | ||
| Anatomy | 1088 | ||
| Subcutaneous Tissues | 1088 | ||
| Muscle and Investing Fascias | 1088 | ||
| Preperitoneal Space and Peritoneum | 1090 | ||
| Vessels and Nerves of the Abdominal Wall | 1090 | ||
| Vascular Supply | 1090 | ||
| Innervation | 1092 | ||
| Abnormalities of the Abdominal Wall | 1093 | ||
| Congenital Abnormalities | 1093 | ||
| Umbilical Hernias | 1093 | ||
| Omphalocele | 1093 | ||
| Gastroschisis | 1093 | ||
| Infantile Umbilical Hernia | 1093 | ||
| Acquired Umbilical Hernia | 1093 | ||
| Abnormalities Resulting from Persistence of the Omphalomesenteric Duct | 1093 | ||
| Abnormalities Resulting from Persistence of the Allantois | 1094 | ||
| Acquired Abnormalities | 1094 | ||
| Diastasis Recti | 1094 | ||
| Anterior Abdominal Wall Hernias | 1094 | ||
| Rectus Sheath Hematoma | 1094 | ||
| Malignancies of the Abdominal Wall | 1095 | ||
| Desmoid Tumor | 1095 | ||
| Abdominal Wall Sarcoma | 1096 | ||
| Metastatic Disease | 1096 | ||
| Symptoms of Intra-Abdominal Disease Referred to the Abdominal Wall | 1096 | ||
| Peritoneum And Peritoneal Cavity | 1097 | ||
| Anatomy | 1097 | ||
| Physiology | 1097 | ||
| Peritoneal Disorders | 1098 | ||
| Ascites | 1098 | ||
| Pathophysiology and Cause | 1098 | ||
| Clinical Presentation and Diagnosis | 1099 | ||
| Ascitic Fluid Analysis | 1099 | ||
| Treatment of Ascites in Cirrhotic Patients | 1099 | ||
| Chylous Ascites | 1100 | ||
| Peritonitis | 1100 | ||
| Spontaneous Bacterial Peritonitis | 1101 | ||
| Tuberculous Peritonitis | 1101 | ||
| Peritonitis Associated With Chronic Ambulatory Peritoneal Dialysis | 1102 | ||
| Malignant Neoplasms of the Peritoneum | 1102 | ||
| Pseudomyxoma Peritonei | 1102 | ||
| Malignant Peritoneal Mesothelioma | 1103 | ||
| Mesentery And Omentum | 1103 | ||
| Embryology and Anatomy | 1103 | ||
| Physiology | 1104 | ||
| Diseases of the Omentum | 1104 | ||
| Omental Cysts | 1104 | ||
| Omental Torsion and Infarction | 1104 | ||
| Omental Neoplasms | 1104 | ||
| Omental Grafts and Transpositions | 1104 | ||
| Diseases of the Mesentery | 1104 | ||
| Mesenteric Cysts | 1104 | ||
| Acute Mesenteric Lymphadenitis | 1105 | ||
| Sclerosing Mesenteritis | 1105 | ||
| Intra-Abdominal (Internal) Hernias | 1106 | ||
| Internal Hernias Caused by Developmental Defects | 1106 | ||
| Mesocolic (Paraduodenal) Hernias | 1106 | ||
| Mesenteric Hernias | 1106 | ||
| Acquired Internal Hernias | 1106 | ||
| Malignancies of the Mesentery | 1106 | ||
| Mesenteric and Intra-Abdominal Desmoid Tumors | 1106 | ||
| Retroperitoneum | 1108 | ||
| Anatomy | 1108 | ||
| Operative Approaches | 1108 | ||
| Retroperitoneal Disorders | 1108 | ||
| Retroperitoneal Abscesses | 1108 | ||
| Retroperitoneal Hematomas | 1109 | ||
| Retroperitoneal Fibrosis | 1109 | ||
| Retroperitoneal Malignancies | 1110 | ||
| Retroperitoneal Sarcoma | 1110 | ||
| Selected References | 1111 | ||
| References | 1112 | ||
| Chapter 46 Hernias | 1114 | ||
| Inguinal Hernias | 1114 | ||
| Incidence | 1114 | ||
| Anatomy of the Groin | 1115 | ||
| External Oblique Muscle and Aponeurosis | 1116 | ||
| Internal Oblique Muscle and Aponeurosis | 1116 | ||
| Transversus Abdominis Muscle and Aponeurosis and Transversalis Fascia | 1116 | ||
| Pectineal (Cooper’s) Ligament | 1117 | ||
| Inguinal Canal | 1117 | ||
| Preperitoneal Space | 1118 | ||
| Femoral Canal | 1119 | ||
| Diagnosis | 1119 | ||
| Classification | 1119 | ||
| Treatment | 1119 | ||
| Nonoperative Management | 1119 | ||
| Operative Repair | 1120 | ||
| Anterior Repairs | 1120 | ||
| Tissue Repairs | 1121 | ||
| Tension-Free Anterior Inguinal Hernia Repair | 1122 | ||
| Preperitoneal Repair | 1123 | ||
| Laparoscopic Repair | 1123 | ||
| Results of Hernia Repair | 1125 | ||
| Femoral Hernias | 1126 | ||
| Special Problems | 1126 | ||
| Sliding Hernia | 1126 | ||
| Recurrent Hernia | 1127 | ||
| Strangulated Hernia | 1127 | ||
| Bilateral Hernias | 1127 | ||
| Complications | 1127 | ||
| Surgical Site Infection | 1127 | ||
| Nerve Injuries and Chronic Pain Syndromes | 1127 | ||
| Ischemic Orchitis and Testicular Atrophy | 1128 | ||
| Injury to the Vas Deferens and Viscera | 1128 | ||
| Hernia Recurrence | 1128 | ||
| Quality of Life | 1128 | ||
| Ventral Hernias | 1128 | ||
| Incidence | 1129 | ||
| Anatomy | 1129 | ||
| Diagnosis | 1129 | ||
| Classification | 1130 | ||
| Umbilical Hernia | 1130 | ||
| Epigastric Hernia | 1131 | ||
| Incisional Hernia | 1131 | ||
| Treatment: Operative Repair | 1131 | ||
| Prosthetic Materials for Ventral Hernia Repair | 1131 | ||
| Synthetic Materials | 1131 | ||
| Biologic Materials | 1132 | ||
| Operative Technique | 1132 | ||
| Ventral Hernias | 1132 | ||
| Intraperitoneal Mesh Placement | 1133 | ||
| Retromuscular Mesh Placement | 1133 | ||
| Component Separation | 1133 | ||
| Endoscopic Component Separation | 1134 | ||
| Results of Incisional Hernia Repairs | 1135 | ||
| Unusual Hernias | 1135 | ||
| Types | 1135 | ||
| Spigelian Hernia | 1135 | ||
| Obturator Hernia | 1137 | ||
| Lumbar Hernia | 1137 | ||
| Interparietal Hernia | 1137 | ||
| Sciatic Hernia | 1137 | ||
| Perineal Hernia | 1137 | ||
| Loss of Domain Hernias | 1137 | ||
| Parastomal Hernia Repair | 1138 | ||
| Complications | 1138 | ||
| Mesh Infection | 1138 | ||
| Seromas | 1138 | ||
| Enterotomy | 1138 | ||
| Selected References | 1138 | ||
| References | 1139 | ||
| Chapter 47 Acute Abdomen | 1141 | ||
| Anatomy and Physiology | 1141 | ||
| History | 1142 | ||
| Physical Examination | 1145 | ||
| Evaluation and Diagnosis | 1147 | ||
| Laboratory Studies | 1147 | ||
| Imaging Studies | 1148 | ||
| Intra-Abdominal Pressure Monitoring | 1150 | ||
| Diagnostic Laparoscopy | 1150 | ||
| Differential Diagnosis | 1151 | ||
| Preparation for Emergency Operation | 1152 | ||
| Atypical Patients | 1152 | ||
| Pregnancy | 1152 | ||
| Critically Ill Patients | 1153 | ||
| Immunocompromised Patients | 1154 | ||
| Morbidly Obese Patients | 1155 | ||
| Algorithms in the Acute Abdomen | 1155 | ||
| Summary | 1156 | ||
| Selected References | 1157 | ||
| References | 1158 | ||
| Chapter 48 Acute Gastrointestinal Hemorrhage | 1160 | ||
| Approach to the Patient | 1160 | ||
| Initial Assessment | 1160 | ||
| Risk Stratification | 1161 | ||
| Resuscitation | 1161 | ||
| History and Physical Examination | 1162 | ||
| Localization | 1162 | ||
| Treatment | 1163 | ||
| Acute Upper GI Hemorrhage | 1164 | ||
| Specific Causes of Upper Gastrointestinal Hemorrhage | 1164 | ||
| Nonvariceal Bleeding | 1164 | ||
| Peptic Ulcer Disease | 1164 | ||
| Treatment | 1165 | ||
| Medical Management | 1165 | ||
| Endoscopic Management | 1166 | ||
| Surgical Management | 1166 | ||
| Mallory-Weiss Tears | 1167 | ||
| Stress Gastritis | 1167 | ||
| Esophagitis | 1168 | ||
| Dieulafoy’s Lesion | 1168 | ||
| Gastric Antral Vascular Ectasia | 1168 | ||
| Malignancy | 1168 | ||
| Aortoenteric Fistula | 1169 | ||
| Hemobilia | 1170 | ||
| Hemosuccus Pancreaticus | 1170 | ||
| Iatrogenic Bleeding | 1170 | ||
| Bleeding Related to Portal Hypertension | 1170 | ||
| Treatment | 1171 | ||
| Medical Management | 1171 | ||
| Endoscopic Management | 1171 | ||
| Other Management | 1171 | ||
| Prevention of Rebleeding | 1172 | ||
| Acute Lower Gastrointestinal Hemorrhage | 1173 | ||
| Diagnosis | 1173 | ||
| Colonoscopy | 1173 | ||
| Radionuclide Scanning | 1174 | ||
| Mesenteric Angiography | 1174 | ||
| Treatment | 1175 | ||
| Specific Causes of Lower GI Bleeding | 1175 | ||
| Colonic Bleeding | 1175 | ||
| Diverticular Disease | 1175 | ||
| Angiodysplasia | 1175 | ||
| Neoplasia | 1176 | ||
| Anorectal Disease | 1176 | ||
| Colitis | 1176 | ||
| Mesenteric Ischemia | 1177 | ||
| Obscure Causes of Acute Gastrointestinal Hemorrhage | 1177 | ||
| Diagnosis | 1178 | ||
| Repeat Endoscopy | 1178 | ||
| Conventional Imaging | 1178 | ||
| Endoscopy | 1178 | ||
| Small Bowel Endoscopy | 1178 | ||
| Video Capsule Endoscopy | 1178 | ||
| Intraoperative Endoscopy | 1179 | ||
| Treatment | 1179 | ||
| Specific Causes of Small Bowel Bleeding | 1179 | ||
| Angiodysplasias | 1179 | ||
| Neoplasia | 1179 | ||
| Crohn’s Disease | 1179 | ||
| Meckel’s Diverticulum | 1179 | ||
| Diverticula | 1179 | ||
| Selected References | 1179 | ||
| References | 1179 | ||
| Chapter 49 Stomach | 1182 | ||
| Anatomy | 1182 | ||
| Gross Anatomy | 1182 | ||
| Divisions | 1182 | ||
| Blood Supply | 1182 | ||
| Lymphatic Drainage | 1182 | ||
| Innervation | 1183 | ||
| Gastric Morphology | 1184 | ||
| Gastric Microscopic Anatomy | 1184 | ||
| Physiology | 1185 | ||
| Regulation of Gastric Function | 1185 | ||
| Gastric Peptides | 1185 | ||
| Gastrin | 1185 | ||
| Somatostatin | 1186 | ||
| Gastrin-Releasing Peptide | 1186 | ||
| Histamine | 1186 | ||
| Ghrelin | 1186 | ||
| Gastric Acid Secretion | 1187 | ||
| Stimulated Acid Secretion | 1187 | ||
| Cephalic Phase | 1187 | ||
| Gastric Phase | 1187 | ||
| Intestinal Phase | 1187 | ||
| Activation and Secretion by the Parietal Cell | 1187 | ||
| Pharmacologic Regulation | 1189 | ||
| Other Gastric Secretory Products | 1189 | ||
| Gastric Juice | 1189 | ||
| Intrinsic Factor | 1189 | ||
| Pepsinogen | 1189 | ||
| Mucus and Bicarbonate | 1189 | ||
| Gastric Motility | 1190 | ||
| Fasting Gastric Motility | 1190 | ||
| Postprandial Gastric Motility | 1190 | ||
| Abnormal Gastric Motility | 1190 | ||
| Gastric-Emptying Studies | 1191 | ||
| Gastric Barrier Function | 1191 | ||
| Peptic Ulcer Disease | 1191 | ||
| Epidemiology | 1191 | ||
| Pathogenesis | 1191 | ||
| Helicobacter pylori Infection | 1191 | ||
| Nonsteroidal Anti-inflammatory Drugs | 1192 | ||
| Acid | 1192 | ||
| Duodenal Ulcer | 1193 | ||
| Clinical Manifestations | 1193 | ||
| Abdominal Pain | 1193 | ||
| Diagnosis | 1193 | ||
| Helicobacter pylori Testing | 1193 | ||
| Serology | 1193 | ||
| Urea Breath Test | 1193 | ||
| Rapid Urease Assay | 1193 | ||
| Histology | 1193 | ||
| Culture | 1193 | ||
| Upper Gastrointestinal Radiography | 1193 | ||
| Fiberoptic Endoscopy | 1194 | ||
| Treatment | 1194 | ||
| Medical Management | 1194 | ||
| Antacids | 1194 | ||
| H2 Receptor Antagonists | 1194 | ||
| Proton Pump Inhibitors | 1194 | ||
| Sucralfate | 1194 | ||
| Treatment of Helicobacter pylori Infection | 1194 | ||
| Complicated Ulcer Disease | 1195 | ||
| Hemorrhage | 1195 | ||
| Perforation | 1196 | ||
| Gastric Outlet Obstruction | 1196 | ||
| Intractable Peptic Ulcer Disease | 1197 | ||
| Surgical Procedures for Peptic Ulcers | 1197 | ||
| Truncal Vagotomy | 1197 | ||
| Highly Selective Vagotomy (Parietal Cell Vagotomy) | 1197 | ||
| Truncal Vagotomy and Antrectomy | 1198 | ||
| Gastric Ulcers | 1198 | ||
| Clinical Manifestations | 1199 | ||
| Diagnosis and Treatment | 1199 | ||
| Type I Gastric Ulcer | 1200 | ||
| Type II or Type III Gastric Ulcers | 1200 | ||
| Type IV Gastric Ulcers | 1200 | ||
| Bleeding Gastric Ulcers | 1200 | ||
| Perforated Gastric Ulcer | 1200 | ||
| Giant Gastric Ulcers | 1201 | ||
| Zollinger-Ellison Syndrome | 1201 | ||
| Stress Gastritis | 1201 | ||
| Pathophysiology | 1202 | ||
| Presentation and Diagnosis | 1202 | ||
| Treatment | 1202 | ||
| Prophylaxis | 1202 | ||
| Postgastrectomy Syndromes | 1202 | ||
| Dumping Syndrome | 1203 | ||
| Metabolic Disturbances | 1203 | ||
| Afferent Loop Syndrome | 1203 | ||
| Efferent Loop Obstruction | 1203 | ||
| Alkaline Reflux Gastritis | 1204 | ||
| Gastric Atony | 1204 | ||
| Gastric Cancer | 1204 | ||
| Epidemiology and Risk Factors | 1204 | ||
| Incidence | 1204 | ||
| Risk Factors | 1204 | ||
| Helicobacter pylori Infection | 1204 | ||
| Dietary Factors | 1205 | ||
| Hereditary Risk Factors and Cancer Genetics | 1205 | ||
| Other Risk Factors | 1206 | ||
| Polyps | 1206 | ||
| Proton Pump Inhibitors | 1206 | ||
| Pathology | 1206 | ||
| Diagnosis and Workup | 1207 | ||
| Signs and Symptoms | 1207 | ||
| Staging | 1207 | ||
| Staging Workup | 1209 | ||
| Endoscopy and Endoscopic Ultrasound | 1209 | ||
| Computed Tomography | 1211 | ||
| Positron Emission Tomography | 1212 | ||
| Laparoscopy | 1212 | ||
| Treatment | 1212 | ||
| Surgical Therapy | 1212 | ||
| Clinical Decision Making | 1215 | ||
| Lymph Node Dissection | 1215 | ||
| Adjuvant and Neoadjuvant Therapy | 1215 | ||
| Palliative Therapy and Systemic Therapy | 1216 | ||
| Complicated Gastric Cancer | 1217 | ||
| Locally Advanced Gastric Cancer | 1217 | ||
| Complications | 1217 | ||
| Outcomes | 1217 | ||
| Recurrence | 1218 | ||
| Surveillance | 1218 | ||
| Gastric Lymphoma | 1218 | ||
| Epidemiology | 1218 | ||
| Pathology | 1218 | ||
| Evaluation | 1218 | ||
| Staging | 1218 | ||
| Treatment | 1219 | ||
| Mucosa-Associated Lymphoid Tissue Lymphomas | 1219 | ||
| Treatment | 1220 | ||
| Gastrointestinal Stromal Tumors | 1220 | ||
| Adjuvant Therapy | 1220 | ||
| Other Neoplasms | 1221 | ||
| Gastric Carcinoid | 1221 | ||
| Heterotopic Pancreas | 1222 | ||
| Other Gastric Lesions | 1222 | ||
| Hypertrophic Gastritis (Ménétrier’s Disease) | 1222 | ||
| Mallory-Weiss Tear | 1222 | ||
| Dieulafoy’s Gastric Lesion | 1222 | ||
| Gastric Varices | 1222 | ||
| Gastric Volvulus | 1223 | ||
| Bezoars | 1224 | ||
| Selected References | 1224 | ||
| References | 1225 | ||
| Chapter 50 Small Intestine | 1227 | ||
| Embryology | 1227 | ||
| Anatomy | 1227 | ||
| Gross Anatomy | 1227 | ||
| Neurovascular-Lymphatic Supply | 1228 | ||
| Microscopic Anatomy | 1229 | ||
| Physiology | 1230 | ||
| Digestion and Absorption | 1230 | ||
| Carbohydrates | 1230 | ||
| Protein | 1232 | ||
| Fats | 1233 | ||
| Emulsification | 1233 | ||
| Micelle Formation | 1233 | ||
| Intracellular Processing | 1233 | ||
| Enterohepatic Circulation | 1233 | ||
| Water, Electrolytes, and Vitamins | 1233 | ||
| Motility | 1234 | ||
| Endocrine Function | 1234 | ||
| Gastrointestinal Hormones | 1234 | ||
| Receptors | 1234 | ||
| Immune Function | 1236 | ||
| Obstruction | 1236 | ||
| Causes | 1237 | ||
| Pathophysiology | 1238 | ||
| Clinical Manifestations and Diagnosis | 1239 | ||
| History | 1239 | ||
| Physical Examination | 1239 | ||
| Radiologic and Laboratory Studies | 1239 | ||
| Simple Versus Strangulating Obstruction | 1241 | ||
| Treatment | 1242 | ||
| Fluid Resuscitation and Antibiotics | 1242 | ||
| Tube Decompression | 1242 | ||
| Operative Management | 1242 | ||
| Management of Specific Problems | 1243 | ||
| Recurrent Intestinal Obstruction | 1243 | ||
| Acute Postoperative Obstruction | 1243 | ||
| Ileus | 1244 | ||
| Inflammatory Diseases | 1244 | ||
| Crohn’s Disease | 1244 | ||
| History | 1244 | ||
| Incidence and Epidemiology | 1244 | ||
| Causes | 1245 | ||
| Infectious Agents | 1245 | ||
| Immunologic Factors | 1245 | ||
| Genetic Factors | 1245 | ||
| Pathology | 1245 | ||
| Gross Pathologic Features | 1245 | ||
| Microscopic Features | 1246 | ||
| Clinical Manifestations | 1247 | ||
| Diagnosis | 1248 | ||
| Management | 1249 | ||
| Medical Therapy | 1249 | ||
| Aminosalicylate | 1249 | ||
| Corticosteroids | 1249 | ||
| Antibiotics | 1250 | ||
| Immunosuppressive Agents | 1250 | ||
| Anticytokine and Cytokine Therapies | 1250 | ||
| Novel Therapies | 1250 | ||
| Nutritional Therapy | 1250 | ||
| Smoking Cessation | 1250 | ||
| Surgical Treatment | 1250 | ||
| Specific Problems | 1251 | ||
| Acute Ileitis (Nonstricturing, Nonpenetrating) | 1251 | ||
| Stricturing Disease | 1251 | ||
| Penetrating Disease | 1252 | ||
| Perforation | 1252 | ||
| Gastrointestinal Bleeding | 1253 | ||
| Urologic Complications | 1253 | ||
| Cancer | 1253 | ||
| Colorectal Disease | 1253 | ||
| Perianal Disease | 1253 | ||
| Duodenal Disease | 1253 | ||
| Prognosis | 1253 | ||
| Typhoid Enteritis | 1254 | ||
| Enteritis in the Immunocompromised Host | 1254 | ||
| Protozoa | 1254 | ||
| Bacteria | 1254 | ||
| Mycobacteria | 1254 | ||
| Viruses | 1255 | ||
| Fungi | 1255 | ||
| Neoplasms | 1255 | ||
| General Considerations | 1255 | ||
| Clinical Manifestations | 1256 | ||
| Diagnosis | 1256 | ||
| Benign Neoplasms | 1257 | ||
| Leiomyomas | 1257 | ||
| Adenomas | 1257 | ||
| Lipomas | 1258 | ||
| Peutz-Jeghers Syndrome | 1258 | ||
| Hemangiomas | 1258 | ||
| Malignant Neoplasms | 1258 | ||
| Carcinoid Tumors | 1259 | ||
| Pathology | 1259 | ||
| Clinical Manifestations | 1259 | ||
| Malignant Carcinoid Syndrome | 1260 | ||
| Diagnosis | 1260 | ||
| Treatment | 1261 | ||
| Surgical Therapy | 1261 | ||
| Medical Therapy | 1262 | ||
| Prognosis | 1262 | ||
| Adenocarcinomas | 1262 | ||
| Lymphoma | 1263 | ||
| Gastrointestinal Stromal Tumors | 1264 | ||
| Metastatic Neoplasms | 1264 | ||
| Diverticular Disease | 1264 | ||
| Duodenal Diverticula | 1265 | ||
| Incidence and Cause | 1265 | ||
| Clinical Manifestations | 1265 | ||
| Treatment | 1266 | ||
| Jejunal and Ileal Diverticula | 1266 | ||
| Incidence and Cause | 1266 | ||
| Clinical Manifestations | 1266 | ||
| Treatment | 1267 | ||
| Meckel’s Diverticulum | 1268 | ||
| Incidence and Cause | 1268 | ||
| Clinical Manifestations | 1268 | ||
| Diagnostic Studies | 1269 | ||
| Treatment | 1269 | ||
| Miscellaneous Problems | 1270 | ||
| Small Bowel Ulcerations | 1270 | ||
| Ingested Foreign Bodies | 1270 | ||
| Small Bowel Fistulas | 1270 | ||
| Clinical Manifestations | 1271 | ||
| Treatment | 1271 | ||
| Stabilization | 1271 | ||
| Staging and Supportive Care | 1271 | ||
| Definitive Management | 1272 | ||
| Pneumatosis Intestinalis | 1272 | ||
| Blind Loop Syndrome | 1273 | ||
| Radiation Enteritis | 1273 | ||
| Short Bowel Syndrome | 1274 | ||
| Treatment | 1275 | ||
| Vascular Compression of the Duodenum | 1276 | ||
| Selected References | 1276 | ||
| References | 1277 | ||
| Chapter 51 The Appendix | 1279 | ||
| Embryology and Anatomy | 1279 | ||
| Appendicitis | 1279 | ||
| Historical Perspective | 1279 | ||
| Pathophysiology | 1279 | ||
| Bacteriology | 1280 | ||
| Diagnosis | 1280 | ||
| History | 1280 | ||
| Physical Examination | 1280 | ||
| Laboratory Studies | 1280 | ||
| Radiographic Studies | 1281 | ||
| Diagnostic Laparoscopy | 1282 | ||
| Special Patient Populations | 1282 | ||
| Diagnostic Algorithm | 1283 | ||
| Treatment | 1284 | ||
| Perforated Appendicitis | 1286 | ||
| Appendiceal Abscess | 1286 | ||
| Chronic or Recurrent Appendicitis | 1286 | ||
| Normal-Appearing Appendix | 1288 | ||
| Appendicitis in Older Patients | 1288 | ||
| Treatment Algorithm | 1289 | ||
| Outcomes | 1289 | ||
| Neoplasms | 1289 | ||
| Selected References | 1291 | ||
| References | 1291 | ||
| Chapter 52 Colon and Rectum | 1294 | ||
| Embryology of the Colon and Rectum | 1294 | ||
| Anatomy of the Colon, Rectum, and Pelvic Floor | 1294 | ||
| Pararectal Fascia | 1296 | ||
| Pelvic Floor | 1296 | ||
| Arterial Supply and Venous and Lymphatic Drainage | 1298 | ||
| Nerves | 1303 | ||
| Physiology of the Colon | 1303 | ||
| Recycling of Nutrients | 1303 | ||
| Colonic Flora | 1303 | ||
| Prebiotics and Probiotics | 1303 | ||
| Fermentation | 1304 | ||
| Short-Chain Fatty Acids | 1306 | ||
| Urea Recycling | 1306 | ||
| Absorption | 1306 | ||
| Secretion | 1307 | ||
| Motility | 1307 | ||
| Formation of Stool | 1307 | ||
| Defecation | 1307 | ||
| Bowel Preparation Before Surgery | 1308 | ||
| Diverticular Disease | 1309 | ||
| Pathogenesis | 1309 | ||
| Diverticulitis | 1310 | ||
| Uncomplicated Diverticulitis | 1311 | ||
| Complicated Diverticulitis | 1312 | ||
| Abscess | 1312 | ||
| Fistula | 1313 | ||
| Generalized Peritonitis | 1313 | ||
| Obstruction | 1314 | ||
| Diverticular-Associated Colitis | 1314 | ||
| Colonic Volvulus | 1314 | ||
| Large Bowel Obstruction and Pseudo-Obstruction | 1317 | ||
| Inflammatory Bowel Disease | 1319 | ||
| Ulcerative Colitis | 1319 | ||
| Epidemiology and Cause | 1319 | ||
| Pathologic Features | 1320 | ||
| Gross Appearance | 1320 | ||
| Histologic Appearance | 1321 | ||
| Clinical Presentation | 1322 | ||
| Extraintestinal Manifestations | 1322 | ||
| Diagnosis | 1322 | ||
| Risk for Carcinoma | 1322 | ||
| Treatment | 1324 | ||
| Medical Therapy | 1324 | ||
| Aminosalicylates | 1324 | ||
| Corticosteroids | 1324 | ||
| Immunomodulatory Medications | 1324 | ||
| Indications for Surgery | 1324 | ||
| Fulminant Colitis and Toxic Megacolon | 1324 | ||
| Massive Bleeding | 1325 | ||
| Intractability | 1325 | ||
| Dysplasia or Carcinoma | 1325 | ||
| Surgical Procedures | 1325 | ||
| Total Proctocolectomy With End Ileostomy | 1326 | ||
| Total Proctocolectomy With Continent Ileostomy | 1326 | ||
| Total Proctocolectomy With Ileal Pouch–Anal Anastomosis | 1326 | ||
| Summary of Elective Operations | 1329 | ||
| Postoperative Care | 1329 | ||
| Crohn’s Colitis | 1330 | ||
| Epidemiology and Cause | 1330 | ||
| Pathologic Features | 1330 | ||
| Gross Appearance | 1330 | ||
| Histologic Appearance | 1330 | ||
| Clinical Presentation | 1330 | ||
| Diagnosis | 1331 | ||
| Treatment | 1331 | ||
| Medical Therapy | 1331 | ||
| Indications for Surgery | 1332 | ||
| Intractability | 1332 | ||
| Intestinal Obstruction | 1332 | ||
| Intra-Abdominal Abscess | 1332 | ||
| Fistulas | 1332 | ||
| Fulminant Colitis and Toxic Megacolon | 1332 | ||
| Massive Bleeding | 1332 | ||
| Cancer | 1332 | ||
| Extracolonic Manifestations | 1332 | ||
| Growth Retardation | 1332 | ||
| Surgical Procedures | 1333 | ||
| Ileocecal Resection | 1333 | ||
| Total Proctocolectomy With End Ileostomy | 1333 | ||
| Total Abdominal Colectomy With Ileorectal Anastomosis or End Ileostomy | 1333 | ||
| Segmental Colon Resection | 1333 | ||
| Postoperative Recurrence | 1334 | ||
| Infectious Colitis | 1334 | ||
| Colonic Ischemia | 1335 | ||
| Neoplasia | 1337 | ||
| Colorectal Cancer Genetics | 1338 | ||
| Specific Genes and Mutations | 1338 | ||
| Tumor Suppressor Genes | 1338 | ||
| MYH Mutations and MYH-Associated Polyposis | 1340 | ||
| Mismatch Repair Genes | 1341 | ||
| Oncogenes | 1341 | ||
| Adenoma-Carcinoma Sequence | 1341 | ||
| Colorectal Polyps | 1342 | ||
| Hereditary Cancer Syndromes | 1345 | ||
| Sporadic Colon Cancer | 1350 | ||
| Staging | 1353 | ||
| Rules for Classification | 1354 | ||
| Clinical Staging | 1354 | ||
| Pathologic Staging | 1354 | ||
| Tumor Regression Grade | 1354 | ||
| Treatment and Follow-Up | 1354 | ||
| Rectal Cancer | 1356 | ||
| Local Excision | 1358 | ||
| Transanal Endoscopic Microsurgery | 1358 | ||
| Fulguration | 1359 | ||
| Abdominal Perineal Resection | 1359 | ||
| Low Anterior Resection | 1359 | ||
| Sphincter-Sparing Abdominal Perineal Resection With Coloanal Anastomosis | 1360 | ||
| Colorectal Cancer Prevention and Screening | 1360 | ||
| Intestinal Stomas | 1362 | ||
| Basic Types | 1362 | ||
| Physiologic Considerations and Practical Implications | 1363 | ||
| Section 11 Chest | 1563 | ||
| Chapter 58 Lung, Chest Wall, Pleura, and Mediastinum | 1564 | ||
| Anatomy | 1564 | ||
| Selection Of Patients For Thoracic Operations | 1568 | ||
| Physiologic Evaluation | 1568 | ||
| Cardiopulmonary Exercise Testing | 1570 | ||
| Thoracic Incisions | 1570 | ||
| Lung | 1571 | ||
| Congenital Lesions | 1571 | ||
| Cystic Lesions | 1571 | ||
| Congenital Bronchopulmonary Malformations | 1571 | ||
| Congenital Abnormalities of the Trachea and Bronchi | 1572 | ||
| Congenital Vascular Disorders | 1573 | ||
| Lung Cancer | 1573 | ||
| Pathology | 1573 | ||
| Screening | 1574 | ||
| Diagnosis | 1574 | ||
| Staging | 1575 | ||
| Evaluation of Stages | 1575 | ||
| T (Tumor) Stage | 1575 | ||
| N (Nodal) Stage | 1575 | ||
| Current American Joint Committee on Cancer Staging System | 1577 | ||
| Tumor (T) | 1577 | ||
| Lymph Nodes (N) | 1578 | ||
| Metastases (M) | 1578 | ||
| Results of Treatment of Lung Cancer According to Stage | 1578 | ||
| Local Therapy for Early-Stage Non–Small Cell Lung Cancer | 1581 | ||
| Neoadjuvant and Adjuvant Therapy | 1582 | ||
| Treatment of Metastatic Disease | 1582 | ||
| Trachea | 1583 | ||
| Tracheal Trauma | 1583 | ||
| Pulmonary Infections | 1586 | ||
| Bronchiectasis | 1586 | ||
| Lung Abscess | 1586 | ||
| Other Bronchopulmonary Disorders | 1586 | ||
| Mycobacterial Infections | 1586 | ||
| Fungal and Parasitic Infections | 1587 | ||
| Massive Hemoptysis | 1589 | ||
| Emphysema And Diffuse Lung Disease | 1589 | ||
| Emphysema | 1589 | ||
| Diffuse Lung Disease | 1590 | ||
| Adult Respiratory Distress Syndrome | 1590 | ||
| Pulmonary Metastases | 1591 | ||
| Surgical Treatment | 1591 | ||
| Miscellaneous Lung Tumors | 1591 | ||
| Chest Wall | 1592 | ||
| Pectus Excavatum | 1592 | ||
| Chest Wall Tumors | 1593 | ||
| Bone Tumors | 1593 | ||
| Soft Tissue Tumors | 1593 | ||
| Metastatic Tumors | 1593 | ||
| Reconstruction | 1594 | ||
| Chest Wall Infections | 1594 | ||
| Chest Wall Trauma | 1594 | ||
| Thoracic Outlet Syndrome | 1594 | ||
| Diagnosis | 1594 | ||
| Diagnostic Tests | 1595 | ||
| Adson (Scalene) Test | 1595 | ||
| Halsted (Costoclavicular) Test | 1595 | ||
| Wright (Hyperabduction) Test | 1595 | ||
| Roos Test | 1595 | ||
| Treatment | 1595 | ||
| Pleura | 1595 | ||
| Pleural Effusions | 1595 | ||
| Benign Pleural Effusions | 1596 | ||
| Malignant Pleural Effusion | 1596 | ||
| Empyema | 1597 | ||
| Chylothorax | 1598 | ||
| Pneumothorax | 1599 | ||
| Mesothelioma | 1599 | ||
| Mediastinum | 1600 | ||
| Anatomy | 1601 | ||
| Anterosuperior Compartment | 1601 | ||
| Middle Compartment | 1601 | ||
| Posterior or Paravertebral Sulci Compartment | 1601 | ||
| Mediastinal Masses and Tumors | 1602 | ||
| Clinical Manifestations and Diagnosis | 1602 | ||
| Evaluation and Diagnostic Imaging | 1602 | ||
| Histologic Diagnosis | 1602 | ||
| Types of Mediastinal Cysts and Tumors | 1602 | ||
| Primary Cysts | 1602 | ||
| Primary Mediastinal Neoplasms | 1603 | ||
| Thymoma | 1603 | ||
| Germ Cell Tumors | 1604 | ||
| Teratomas | 1604 | ||
| Malignant Nonteratomatous Germ Cell Tumors | 1604 | ||
| Seminomas | 1604 | ||
| Nonseminomatous Tumors | 1604 | ||
| Neurogenic Tumors | 1605 | ||
| Ganglion Tumors | 1605 | ||
| Paraganglioma (Pheochromocytoma) | 1605 | ||
| Lymphomas | 1605 | ||
| Endocrine Tumors | 1606 | ||
| Thyroid Tumors | 1606 | ||
| Parathyroid Tumors | 1606 | ||
| Neuroendocrine Tumors | 1606 | ||
| Selected References | 1606 | ||
| References | 1607 | ||
| Chapter 59 Congenital Heart Disease | 1611 | ||
| History and Other Considerations | 1611 | ||
| Pathways For Practicing Congenital Heart Surgery | 1611 | ||
| Anatomy, Terminology, and Diagnosis | 1612 | ||
| Anatomy and Terminology | 1612 | ||
| Diagnosis | 1613 | ||
| Physical Examination | 1613 | ||
| Diagnostic Tests | 1614 | ||
| Pulse Oximetry | 1614 | ||
| Plain Radiography | 1614 | ||
| Electrocardiography | 1614 | ||
| Echocardiography | 1614 | ||
| Magnetic Resonance Imaging and Computed Tomography | 1614 | ||
| Cardiac Catheterization | 1615 | ||
| Perioperative Care | 1616 | ||
| Anesthesia Pitfalls | 1616 | ||
| Neurologic Outcomes | 1617 | ||
| Lesion Overview | 1617 | ||
| Defects Associated With Increased Pulmonary Blood Flow | 1617 | ||
| Persistent Arterial Duct (Patent Ductus Arteriosus) | 1617 | ||
| Aortopulmonary Septal Defect (Aortopulmonary Window) | 1618 | ||
| Atrial Septal Defect | 1618 | ||
| Ventricular Septal Defect | 1620 | ||
| Perimembranous Ventricular Septal Defect | 1620 | ||
| Muscular Ventricular Septal Defect | 1620 | ||
| Subarterial (Supracristal or Outlet) Ventricular Septal Defect | 1620 | ||
| Atrioventricular Septal Defect (Atrioventricular Canal Defect) | 1621 | ||
| Adult Patient With Atrioventricular Septal Defect | 1622 | ||
| Persistent Arterial Trunk (Truncus Arteriosus) | 1623 | ||
| Abnormalities of Venous Drainage | 1624 | ||
| Total Anomalous Pulmonary Venous Return | 1624 | ||
| Obstructed Total Anomalous Pulmonary Venous Return | 1625 | ||
| Cor Triatriatum | 1625 | ||
| Anomalous Systemic Venous Drainage | 1626 | ||
| Cyanotic Congenital Heart Disease | 1626 | ||
| Tetralogy of Fallot | 1626 | ||
| Pulmonary Atresia and Intact Ventricular Septum | 1628 | ||
| Pulmonary Atresia With Ventricular Septal Defect | 1629 | ||
| Valvular Pulmonic Stenosis | 1630 | ||
| Conotruncal Anomalies | 1630 | ||
| Transposition of the Great Arteries | 1630 | ||
| Transposition of the Great Arteries–Intact Ventricular Septum | 1631 | ||
| Transposition of the Great Arteries–Ventricular Septal Defect With or Without Arch Hypoplasia | 1632 | ||
| Transposition of the Great Arteries–Ventricular Septal Defect With Pulmonary Stenosis–Left Ventricular Outflow Tract Obstruction or Pulmonary Atresia | 1632 | ||
| Transposition of the Great Arteries in Adults | 1632 | ||
| Double-Outlet Right Ventricle | 1632 | ||
| Congenitally Corrected Transposition of the Great Arteries (l-Transposition) | 1632 | ||
| Congenitally Corrected Transposition of the Great Arteries With Intact Ventricular Septum | 1633 | ||
| Congenitally Corrected Transposition of the Great Arteries With Ventricular Septal Defect and Pulmonic Stenosis | 1633 | ||
| Left Ventricular Outflow Tract Obstruction | 1633 | ||
| Valvular Aortic Stenosis | 1634 | ||
| Fibromuscular Subaortic Stenosis | 1635 | ||
| Tunnel Subaortic Stenosis | 1635 | ||
| Aortic Arch Anomalies | 1635 | ||
| Aortic Coarctation | 1635 | ||
| Interrupted Aortic Arch | 1636 | ||
| Single Ventricle | 1637 | ||
| Tricuspid Atresia | 1638 | ||
| Hypoplastic Left Heart Syndrome | 1638 | ||
| Neonatal Cardiac Transplantation | 1639 | ||
| Norwood Reconstruction | 1639 | ||
| Sano Modification of Norwood’s Operation | 1640 | ||
| Hybrid Procedure | 1640 | ||
| Fontan Operation | 1641 | ||
| Miscellaneous Anomalies | 1643 | ||
| Vascular Rings and Pulmonary Artery Slings | 1643 | ||
| Vascular Rings | 1643 | ||
| Complete Vascular Rings | 1643 | ||
| Partial Vascular Rings | 1643 | ||
| Pulmonary Artery Slings | 1643 | ||
| Section 12 Vascular | 1696 | ||
| Chapter 62 The Aorta | 1697 | ||
| Aneurysmal Disease | 1697 | ||
| Diagnosis | 1697 | ||
| Risk of Rupture | 1698 | ||
| Screening and Surveillance Recommendations | 1699 | ||
| Treatment | 1699 | ||
| Medical Therapy | 1699 | ||
| Surgical Treatment | 1699 | ||
| Preoperative Evaluation | 1699 | ||
| Technique of Open Surgical Repair of Abdominal Aortic Aneurysms | 1701 | ||
| Postoperative Management | 1705 | ||
| Endovascular Repair | 1707 | ||
| Thoracic and Thoracoabdominal Aortic Aneurysms | 1707 | ||
| Open Repair of Thoracic and Thoracoabdominal Aneurysms | 1707 | ||
| Endovascular Management of Thoracic and Thoracoabdominal Aneurysms | 1708 | ||
| Aortoiliac Occlusive Disease | 1710 | ||
| Presentation and Evaluation | 1712 | ||
| Treatment | 1712 | ||
| Technique of Open Reconstruction | 1712 | ||
| Aortofemoral Bypass Grafting | 1712 | ||
| Axillofemoral Bypass Grafting | 1713 | ||
| Femorofemoral Artery Bypass Grafting | 1713 | ||
| Iliofemoral Artery Bypass Grafting | 1713 | ||
| Aortoiliac Endarterectomy | 1713 | ||
| Complications of Aortic Surgery | 1715 | ||
| Surgical Treatment of Anastomotic Pseudoaneurysms | 1717 | ||
| Aortic Dissection | 1718 | ||
| References | 1722 | ||
| Chapter 63 Peripheral Arterial Occlusive Disease | 1725 | ||
| Epidemiology | 1725 | ||
| Basic Science of Vascular Disease | 1725 | ||
| Vascular Wall Microanatomy | 1725 | ||
| Atherosclerosis | 1726 | ||
| Evaluating And Treating The Patient With Peripheral Arterial Disease | 1727 | ||
| History and Physical Examination | 1727 | ||
| Chronic Arterial Insufficiency | 1727 | ||
| Physiologic Testing and Imaging | 1729 | ||
| Imaging Studies | 1733 | ||
| Angiography | 1733 | ||
| Computed Tomography Angiography | 1735 | ||
| Magnetic Resonance Angiography | 1735 | ||
| Carbon Dioxide Angiography | 1735 | ||
| Intravascular Ultrasound | 1735 | ||
| Treatment | 1735 | ||
| Medical Treatment | 1735 | ||
| Revascularization: Surgical Treatment | 1738 | ||
| Intermittent Claudication | 1738 | ||
| Critical Limb Ischemia | 1738 | ||
| Diabetic Foot | 1738 | ||
| Lower Extremity Amputations | 1740 | ||
| Ray Amputation | 1741 | ||
| Transmetatarsal Amputation | 1741 | ||
| Below-Knee Amputation | 1742 | ||
| Above-Knee Amputation | 1742 | ||
| Surgical Revascularization Procedures | 1743 | ||
| Open Surgical Management | 1743 | ||
| Aortoiliac Disease | 1743 | ||
| Lower Extremity Occlusive Disease | 1743 | ||
| Complications | 1747 | ||
| Endovascular Management | 1747 | ||
| Subintimal Angioplasty | 1747 | ||
| Balloon Angioplasty | 1748 | ||
| Stenting | 1748 | ||
| Stent Graft | 1749 | ||
| Other Variations of Balloon Angioplasty | 1751 | ||
| Cutting Balloon | 1751 | ||
| Cryoplasty | 1751 | ||
| Atherectomy | 1751 | ||
| Acute Limb Ischemia | 1751 | ||
| Other Causes Of Acute And Chronic Limb Ischemia | 1752 | ||
| Nonatherosclerotic Arteriopathies | 1752 | ||
| Buerger’s Disease | 1752 | ||
| Vasculitis | 1753 | ||
| Large-Vessel Vasculitis | 1753 | ||
| Giant Cell Arteritis (Temporal Arteritis) | 1753 | ||
| Takayasu’s Disease | 1753 | ||
| Medium-Vessel Vasculitis | 1753 | ||
| Polyarteritis Nodosa | 1753 | ||
| Kawasaki’s Disease | 1753 | ||
| Behçet’s Disease | 1754 | ||
| Cogan’s Syndrome | 1754 | ||
| Small-Vessel Vasculitis | 1754 | ||
| Antineutrophil Cytoplasmic Antibody–Associated Vasculitides | 1754 | ||
| Vasculitis Associated With Connective Tissue Diseases | 1754 | ||
| Heritable Arteriopathies | 1754 | ||
| Cystic Medial Necrosis | 1754 | ||
| Pseudoxanthoma Elasticum | 1754 | ||
| Arteria Magna Syndrome | 1754 | ||
| Congenital Conditions Affecting the Arteries | 1754 | ||
| Persistent Sciatic Artery | 1754 | ||
| Popliteal Entrapment Syndromes | 1755 | ||
| Adventitial Cystic Disease | 1755 | ||
| Peripheral Artery Aneurysms | 1755 | ||
| Femoral and Popliteal Artery Aneurysms | 1755 | ||
| Evaluating the Success of Revascularization Procedures | 1755 | ||
| Renal Artery Disease | 1758 | ||
| Diagnosis | 1758 | ||
| Magnetic Resonance Angiography | 1758 | ||
| Treatment | 1759 | ||
| Open Renal Artery Bypass | 1759 | ||
| Renal Artery Stenting | 1759 | ||
| Value, Limitations, and Techniques | 1759 | ||
| Renal Angioplasty and Stent Procedure | 1760 | ||
| Renal Artery Access and Guide Sheath Positioning | 1760 | ||
| Renal Angioplasty | 1761 | ||
| Stent Placement | 1761 | ||
| Completion Angiography | 1761 | ||
| Technical Tips | 1761 | ||
| Splanchnic Aneurysms: Splenic, Mesenteric, and Renal Artery Aneuryms | 1761 | ||
| Carotid Artery Disease | 1763 | ||
| Pathophysiology | 1763 | ||
| Clinical Presentation | 1763 | ||
| Diagnosis | 1763 | ||
| Treatment | 1764 | ||
| Carotid Endarterectomy | 1764 | ||
| Indications | 1764 | ||
| Proven Indications | 1765 | ||
| Acceptable But Not Proven Indications | 1765 | ||
| Uncertain Indications | 1765 | ||
| Proven Inappropriate Indications | 1766 | ||
| Technique | 1766 | ||
| Postoperative Care | 1767 | ||
| Complications | 1768 | ||
| Carotid Angioplasty and Stent Procedure | 1768 | ||
| Indications and Contraindications | 1768 | ||
| Technique | 1769 | ||
| Carotid Artery Access and Guide Sheath Positioning | 1769 | ||
| Placement of Embolic Protection Device | 1769 | ||
| Carotid Stent Placement | 1769 | ||
| Carotid Angioplasty | 1769 | ||
| Completion Angiogram | 1769 | ||
| Conclusions | 1770 | ||
| Dialysis Access | 1771 | ||
| Dialysis Outcomes Quality Initiative (DOQI) Guidelines | 1771 | ||
| Dialysis Outcome Quality Initiative Guidelines | 1771 | ||
| Nomenclature | 1771 | ||
| Superficial Venous System of the Upper Extremity | 1771 | ||
| Cephalic Vein | 1772 | ||
| Basilic Vein | 1772 | ||
| Median Antebrachial Vein | 1772 | ||
| Initial Evaluation for New Access | 1772 | ||
| Central Venous Catheters | 1772 | ||
| Types of Venous Transpositions | 1773 | ||
| Upper Arm Venous Transposition | 1773 | ||
| Forearm Venous Transpositions | 1773 | ||
| Lower Extremity Venous Transpositions | 1774 | ||
| Techniques of Venous Transposition | 1774 | ||
| Patient Assessment and Selection of Optimal Site | 1774 | ||
| Superficial Venous Transposition of the Forearm | 1775 | ||
| Superficial Venous Transposition of the Arm | 1775 | ||
| Follow-Up | 1776 | ||
| Patients With Failing or Failed Access | 1776 | ||
| Secondary Interventions in Autogenous Fistulas | 1777 | ||
| Complex Access | 1777 | ||
| Vascular Access Complications | 1778 | ||
| Conclusion | 1778 | ||
| Selected References | 1779 | ||
| References | 1779 | ||
| Chapter 64 Vascular Trauma | 1785 | ||
| General Approach To Vascular Trauma | 1785 | ||
| Mechanism of Injury | 1785 | ||
| Clinical Presentation | 1786 | ||
| Diagnosis | 1786 | ||
| Physical Examination | 1786 | ||
| Treatment | 1787 | ||
| Minimal Vascular Injury and Nonoperative Management | 1787 | ||
| Endovascular Management | 1788 | ||
| Torso Injuries | 1788 | ||
| Cerebrovascular Injuries | 1788 | ||
| Extremity Vascular Injury | 1789 | ||
| Who Should Perform Endovascular Repairs? | 1789 | ||
| Surgical Treatment | 1789 | ||
| Preparation for Operative Management | 1789 | ||
| Vascular Exposure and Control | 1790 | ||
| Vascular Damage Control | 1790 | ||
| Choice of Repair and Graft Material | 1791 | ||
| Intraoperative Imaging and Noninvasive Evaluation | 1791 | ||
| Role of Tissue Coverage | 1791 | ||
| Fasciotomy | 1792 | ||
| Role of Immediate Amputation | 1792 | ||
| Common Errors and Pitfalls | 1792 | ||
| Specific Injuries | 1792 | ||
| Head, Neck, and Thoracic Outlet | 1792 | ||
| Intrathoracic Great Vessel Injuries | 1793 | ||
| Abdominal Vascular Injury | 1794 | ||
| Upper Extremity | 1795 | ||
| Lower Extremity | 1797 | ||
| Operative Techniques For Extremity Fasciotomy | 1797 | ||
| Postoperative Management | 1798 | ||
| Outcomes And Follow-Up | 1798 | ||
| Selected References | 1798 | ||
| References | 1799 | ||
| Chapter 65 Venous Disease | 1801 | ||
| Anatomy | 1801 | ||
| Superficial Venous System | 1801 | ||
| Deep Venous System | 1801 | ||
| Perforating Venous System | 1801 | ||
| Normal Venous Histology and Function | 1802 | ||
| Venous Insufficiency | 1803 | ||
| Primary Venous Insufficiency | 1803 | ||
| Pathology | 1804 | ||
| Mechanical Abnormalities | 1804 | ||
| Cellular Abnormalities | 1804 | ||
| Molecular Abnormalities | 1804 | ||
| Risk Factors | 1804 | ||
| Symptoms | 1805 | ||
| Physical Examination | 1805 | ||
| Diagnostic Evaluation of Venous Dysfunction | 1805 | ||
| Phlebography and Venography | 1806 | ||
| Magnetic Resonance Venous Imaging | 1806 | ||
| Classification Systems | 1806 | ||
| Treatment of Superficial Venous Insufficiency | 1806 | ||
| Nonoperative Management | 1806 | ||
| Venous Ablation of Telangiectasias | 1808 | ||
| Surgical Management | 1809 | ||
| Surgery for Axial Venous Incompetence | 1809 | ||
| Secondary Venous Insufficiency | 1811 | ||
| Treatment | 1811 | ||
| Surgery for Deep Venous Insufficiency | 1811 | ||
| Direct Venous Reconstruction | 1812 | ||
| Deep Venous Thrombosis | 1812 | ||
| Lower Extremity Deep Venous Thrombosis | 1812 | ||
| Causes | 1813 | ||
| Stasis | 1813 | ||
| Hypercoagulable State | 1813 | ||
| Venous Injury | 1813 | ||
| Diagnostic Considerations | 1813 | ||
| Incidence | 1813 | ||
| Clinical Diagnosis | 1813 | ||
| Imaging Studies and Laboratory Tests | 1814 | ||
| Venography | 1814 | ||
| Impedance Plethysmography | 1814 | ||
| Fibrin and Fibrinogen Assays | 1814 | ||
| Duplex Ultrasound | 1814 | ||
| Magnetic Resonance Venous Imaging | 1814 | ||
| Prophylaxis | 1814 | ||
| Treatment | 1815 | ||
| Thrombolysis | 1815 | ||
| Endovascular Reconstruction | 1815 | ||
| Upper Extremity Deep Venous Thrombosis | 1816 | ||
| Treatment | 1816 | ||
| Vena Cava Filter | 1816 | ||
| Retrievable Vena Cava Filters | 1816 | ||
| Superficial Thrombophlebitis | 1816 | ||
| Conclusion | 1817 | ||
| Selected References | 1817 | ||
| References | 1817 | ||
| Chapter 66 The Lymphatics | 1819 | ||
| Embryology and Anatomy | 1819 | ||
| Function and Structure | 1819 | ||
| Pathophysiology and Staging | 1820 | ||
| Differential Diagnosis | 1820 | ||
| Classification | 1821 | ||
| Diagnostic Tests | 1821 | ||
| New Diagnostic Tests | 1822 | ||
| Treatment | 1822 | ||
| General Therapeutic Measures | 1822 | ||
| Specific Treatment Measures | 1822 | ||
| Elevation and Compression Garments | 1822 | ||
| Complex Decongestive Physical Therapy | 1822 | ||
| Compression Pump Therapy | 1823 | ||
| Drug Therapy | 1823 | ||
| Molecular Lymphangiogenesis | 1823 | ||
| Operative Treatment | 1823 | ||
| Lymphatic Disorders | 1825 | ||
| Chylothorax | 1825 | ||
| Chyloperitoneum | 1825 | ||
| Tumors of the Lymphatics | 1825 | ||
| Selected References | 1826 | ||
| References | 1826 | ||
| Section 13 Specialties in General Surgery | 1828 | ||
| Chapter 67 Pediatric Surgery | 1829 | ||
| Newborn Physiology | 1829 | ||
| Cardiovascular System | 1829 | ||
| Pulmonary System | 1829 | ||
| Thermoregulation | 1830 | ||
| Immunologic Function | 1830 | ||
| Fluids, Electrolytes, and Nutrition | 1830 | ||
| Fluid Requirements | 1830 | ||
| Nutrition | 1830 | ||
| Total Parenteral Nutrition | 1830 | ||
| Caloric Requirements | 1831 | ||
| Protein | 1831 | ||
| Carbohydrate | 1831 | ||
| Fat | 1831 | ||
| Neck Lesions | 1831 | ||
| Cervical Lymphadenopathy | 1831 | ||
| Cystic Hygroma | 1832 | ||
| Thyroglossal Duct Cyst | 1832 | ||
| Branchial Cleft Remnants | 1833 | ||
| Torticollis | 1833 | ||
| Extracorporeal Life Support | 1833 | ||
| Indications | 1833 | ||
| Physiologic Considerations | 1833 | ||
| Complications | 1834 | ||
| Congenital Diaphragmatic Hernia | 1834 | ||
| Pathogenesis | 1834 | ||
| Clinical Presentation | 1835 | ||
| Diagnosis | 1835 | ||
| Treatment | 1835 | ||
| Surgical Repair | 1835 | ||
| Outcomes | 1836 | ||
| Bronchopulmonary Malformations | 1836 | ||
| Bronchogenic Cyst | 1836 | ||
| Congenital Pulmonary Airway Malformation | 1836 | ||
| Pulmonary Sequestration | 1836 | ||
| Congenital Lobar Emphysema | 1837 | ||
| Alimentary Tract | 1837 | ||
| Esophageal Atresia and Tracheoesophageal Fistula | 1837 | ||
| Clinical Presentation and Diagnosis | 1837 | ||
| Treatment | 1838 | ||
| Preoperative Management | 1838 | ||
| Surgical Management | 1838 | ||
| Gastroesophageal Reflux | 1839 | ||
| Clinical Presentation | 1840 | ||
| Evaluation | 1840 | ||
| Treatment | 1840 | ||
| Hypertrophic Pyloric Stenosis | 1841 | ||
| Clinical Presentation | 1841 | ||
| Index | 2079 | ||
| A | 2079 | ||
| B | 2083 | ||
| C | 2085 | ||
| D | 2091 | ||
| E | 2092 | ||
| F | 2094 | ||
| G | 2095 | ||
| H | 2097 | ||
| I | 2100 | ||
| J | 2102 | ||
| K | 2102 | ||
| L | 2102 | ||
| M | 2104 | ||
| N | 2107 | ||
| O | 2108 | ||
| P | 2108 | ||
| Q | 2113 | ||
| R | 2113 | ||
| S | 2115 | ||
| T | 2119 | ||
| U | 2121 | ||
| V | 2122 | ||
| W | 2123 | ||
| X | 2124 | ||
| Y | 2124 | ||
| Z | 2124 |