BOOK
LIC - Sabiston Textbook of Surgery
Courtney M. Townsend Jr. | R. Daniel Beauchamp | B. Mark Evers | Kenneth L. Mattox
(2015)
Additional Information
Book Details
Abstract
LIC - Sabiston Textbook of Surgery
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 |