Excerpt

"Surgical Treatment – Evidence-Based and Problem-Oriented" is based upon a concept which the editors believe will become increasingly important in the preparation of clinical textbooks in the 21st century, namely the quality of the evidence upon which currently accepted clinical practice is based needs to be assessed frankly and taken into account when recommendations for patient treatment are made. As is apparent in many of the chapters in this volume, the authors are frequently forced to conclude that a higher level of evidence than is currently available would be necessary in order establish the validity of the currently accepted management of a wide variety of common surgical problems. The editors believe this is a fact of which both students and surgical practitioners need to be aware, so that they may be prepared to update and alter their clinical decision making on the basis of higher levels of evidence when these become available. The editors also hope that increasing awareness of the low level of evidence upon which much present day surgical practice is based will prompt surgeons from many countries to plan or at least participate in clinical trials to achieve a higher quality of evidence upon which to base a more rational clinical practice.

Contents

• Preface
• Authors
• Part I. Esophagus
  • Carcinoma of the esophagus and gastro-esophageal junction
    Toni Lerut.
    • Epidemiology – etiology – pathology
    • Diagnosis
    • Staging and classification
    • Surgical treatment
    • References
  • Radiation therapy of esophageal cancer
    Abram Recht, M.D.
    • Introduction
    • Inoperable cancers: chemoradiotherapy versus supportive care
    • Inoperable cancers: radiotherapy versus chemoradiotherapy
    • Resectable cancers: radiotherapy versus surgery
    • Resectable cancers: preoperative or postoperative radiotherapy versus surgery alone
    • Resectable cancers: preoperative chemotherapy and radiotherapy versus surgery alone
    • Discussion
    • Conclusions
    • References
  • Gastro-esophageal reflux disease (GERD)
    P Gorecki, M.D.
    • Definition, epidemiology and pathogenesis of GERD
    • Diagnostic tests
    • Therapy
    • Nissen Fundoplication
    • Partial fundoplications
    • Summary
    • References
  • Peptic strictures of the esophagus
    Christopher M Schlachta, Eric C Poulin, Joseph Mamazza, and Pieter A Seshadri.
    • Pathophysiology
    • Diagnosis
    • Management
    • Mallory-Weiss Syndrome
    • Diagnosis and pathogenesis
    • Therapy
    • References
  • Instrumental perforation of the esophagus
    Jarmo A Salo and Eero I T Sihvo.
    • Causes
    • Pathogenesis
    • Prognosis
    • Diagnosis
    • Treatment
    • References
• Part II. Stomach-Duodenum
  • Preoperative staging for gastric cancer
    J. R Siewert, M.D. and A. Sendler, M.D.
    • Primary tumor, T-category
    • Nodal involvement, N-category
    • Distant metastases - M-category
    • References
  • Surgical management of gastric cancer
    Simon Msika, Grégoire Deroide, and Reza Kianmanesh.
    • Surgical treatment
    • Non surgical treatment
    • References
  • Surgery for gastric remnant carcinoma following Billroth II gastrectomy
    L Filez and F Penninckx.
    • Definition
    • Incidence
    • Pathogenesis
    • Symptoms
    • Diagnosis
    • Staging
    • Treatment
    • Complications
    • Prognosis
    • Prevention
    • References
  • Malignant tumors of the duodenum
    Pierre-Louis Fagniez and Nelly Rotman.
    • Incidence
    • Clinical presentation
    • Diagnosis
    • Preoperative staging
    • Treatment
    • Prognostic assessment
    • References
  • Primary gastric lymphoma
    V Speranza and D Lomanto.
    • Introduction
    • Pathology
    • Staging
    • Clinical signs and diagnosis
    • Prognostic factors
    • Therapeutic modalities
    • Controversies
    • Eradication Therapy
    • Conclusions
    • References
  • Benign tumors of the duodenum and stomach
    Peter M Y Goh, M.D. and Jorge E Lenzi, M.D.
    • Introduction
    • Classification
    • Presenting symptoms and diagnosis
    • Treatment Options
    • References
  • Management of perforated duodenal ulcer
    Andrew G Hill, M.D. Fracs.
    • Introduction
    • Pathogenesis and epidemiology
    • Diagnosis
    • Risk Stratification
    • Treatment
    • Conclusion
    • References
  • Gastric surgery for morbid obesity
    Edward E Mason, M.D.
    • Weight control mechanisms
    • HCl and stomal ulceration
    • The informed patient and operative choice
    • Malnutrition avoidance; emesis no, anamnesis yes
    • References
  • Duodenal diverticula
    Jerry M Shuck, M.D. and Anthony Stallion, M.D.
    • Clinical implications
    • Surgical implications
    • Surgical challenges
    • Conclusions
    • References
• Part III. Small Bowel
  • Adenocarcinoma of the small bowel
    Alfred I Neugut, M.D., Michael R Marvin, Ph.D., and John A Chabot, M.D.
    • Introduction
    • Incidence
    • Etiology
    • Clinical presentation and diagnosis
    • Stage/grade distributions
    • Treatment
    • Conclusions
    • References
  • Small bowel obstruction
    M. N Kulaylat and R. J Doerr.
    • Definition, classification, and etiology
    • Pathophysiologic changes
    • Diagnosis of acute small bowel obstruction
    • Treatment of acute small bowel obstruction
    • References
  • Mesenteric ischemia
    Ulf Haglund, M.D.
    • Definition, pathogenesis and epidemiology
    • Clinical stages
    • Diagnosis
    • Treatment
    • References
  • Surgical management of Crohn's disease
    Scott A Strong, M.D.
    • Introduction
    • Classifications, operative incidence, and operative indications
    • Operative options
    • Conclusions
    • References
  • Surgical therapy of recurrent Crohn's disease
    H.J. Buhr and A.J. Kroesen.
    • Definition of recurrence
    • Factors influencing recurrence
    • Surgical principals in recurrent Crohn's disease
    • Conclusion
    • References
  • Meckel's diverticulum
    Anthony Stallion, M.D. and Jerry M Shuck, M.D.
    • Epidemiology
    • Embryology and anatomy
    • Clinical presentation
    • Diagnosis
    • Management
    • Conclusion
    • References
  • Postoperative enterocutaneous fistula
    Timothy A Pritts, M.D., David R Fischer, M.D., and Josef E Fischer, M.D.
    • Introduction
    • Definition and classification
    • Diagnosis
    • Treatment
    • References
  • Short bowel syndrome
    Malcolm K Robinson, M.D. and Douglas W Wilmore, M.D.
    • Definition and pathogenesis
    • Initial treatment and nutritional management
    • Growth factors
    • Surgical treatments and intestinal transplantation
    • Designing a treatment plan based on predicted outcome
    • Conclusion
    • References
  • Intestinal transplantation
    Christoph Troppmann, M.D. and Rainer W G Gruessner, M.D.
    • Introduction
    • Intestinal failure and indications for intestinal and multivisceral transplantation
    • Contraindications
    • Preoperative evaluation
    • Operative technique (basic steps)
    • Postoperative management
    • Immunosuppression
    • Posttransplant complications
    • Clinical intestinal transplant outcome
    • References
• Part IV. Colon
  • Colorectal cancer
    A. Shankar and I. Taylor.
    • Incidence
    • Screening
    • Surgical treatment of colorectal cancer
    • Emergency surgery
    • Adjuvant treatment
    • Advanced disease
    • Liver resection
    • Conclusion
    • References
  • Surgical management of rectal carcinoma
    Lars Påhlman.
    • Introduction
    • Local control
    • Functional outcome
    • Conclusion
    • References
  • Locoregional recurrence of rectal cancer
    Johan N Wiig, M.D. and Odd Søreide, M.D.
    • Definition, reporting and extent of disease
    • Natural history of LR
    • Detection and preoperative assessment
    • Treatment
    • Conclusion
    • References
  • Benign tumors of the colon and rectum
    M. Zuber and F. Harder.
    • NON-NEOPLASTIC POLYPS
    • Hyperplastic polyps
    • Inflammatory polyps
    • Lymphoid polyps
    • NEOPLASTIC EPITHELIAL POLYPS
    • Mesenchymal lesions
    • Neuroma
    • Angioma
    • References
  • Diverticulitis
    Moshe Schein, M.D. and Ramesh Paladugn, M.D.
    • Introduction
    • Pathophysiology
    • Clinical manifestation
    • Level of evidence
    • Diagnosis
    • Non operative treatment
    • Management of ‘diverticular abscesses’
    • Emergency surgery for acute diverticulitis
    • Emerging therapies
    • After the emergency
    • Conclusions
    • References
  • Obstruction of the colon (benign pathology)
    J.J. Tuech, M.D., P. Pessaux, and J.P. Arnaud, M.D.
    • Volvulus of the colon
    • Sigmoid diverticulitis
    • Others
    • References
  • Surgical management of ulcerative colitis
    F.A. Frizelle, MBChB and M.J. Burt, MBChB.
    • Introduction
    • Indications for surgery
    • Surgical options
    • Special circumstances
    • Conclusion
    • References
  • Lower gastrointestinal tract bleeding: a problem based approach
    J Martin Perez, M.D. and Stephen M Cohn, M.D.
    • Clinical presentation
    • History and physical examination
    • Diagnosis and therapeutics
    • References
  • Management of complications of colonoscopy
    Stephen M Kavic, M.D. and Marc D Basson, M.D.
    • Perforation
    • Hemorrhage
    • Diagnosis
    • Management
    • Conclusion
    • References
  • Appendicitis
    Per-Olof Nyström, M.D.
    • Introduction
    • Increasing the diagnostic accuracy
    • Clinical diagnosis of appendicitis
    • Specific components of the appendectomy
    • Antibiotic prophylaxis and therapy
    • Primary closure of the wound or delayed
    • The appendix stump
    • Laparoscopic appendectomy
    • Comments
    • References
• Part V. Anal
  • Anal fissure
    M. Jonas and J.H. Scholefield.
    • Introduction
    • Pathogenesis
    • Treatment
    • The future
    • References
  • Rectal prolapse
    Christian T Hamel, M.D. and Steven D Wexner, M.D.
    • Definition, pathogenesis
    • Diagnosis
    • Differential diagnosis
    • Conclusion
    • References
  • Anal abscess and fistula
    H.J. Mappes and E.H. Farthmann.
    • Classification and pathological anatomy
    • Symptoms
    • Diagnosis
    • Therapy
    • Anal fistula
    • Transsphincteric fistulae
    • Extrasphincteric fistulae
    • Recto-vaginal fistulae
    • References
  • Complicated anorectal sepsis
    P.A. Gervaz and S.D. Wexner.
    • Introduction
    • Anorectal sepsis in Crohn's disease
    • Surgical management
    • Anorectal sepsis in AIDS
    • Anorectal sepsis in patients with hematologic diseases
    • Postoperative anorectal sepsis
    • References
  • Anal incontinence
    Charles B S Tsang and Francis Seow-Choen.
    • Introduction
    • The continence mechanism
    • Causes of anal incontinence
    • Current treatment of anal incontinence
    • Conclusion
    • References
  • Surgical Treatment of Haemorrhoids
    René G Holzheimer.
    • Classification
    • Pathogenesis
    • Symptoms
    • Differential diagnosis
    • Treatment options for haemorrhoids include
    • Treatment modalities for haemorrhoids
    • Additional treatment for haemorrhoids
    • References
• Part VI. Hepatic
  • Hepatocellular cancer: resection or transplantation
    Galal El-Gazzaz, Janek Dmitrewski, and Paul McMaster.
    • Resection or transplantation for hepatocellular carcinoma
    • Conclusions
    • References
  • Multimodality treatment for hepatocellular carcinoma
    Zhao-You Tang.
    • General consideration of HCC
    • Staging of HCC
    • Evolution of HCC treatment
    • Selection of treatment modality
    • Implication of multimodality combination treatment for HCC
    • HAL combined with HAI and followed by resection
    • TACE and followed by resection
    • Resection followed by TACE and other treatment
    • Multimodality treatment of recurrent HCC
    • TACE, PEI and their combination
    • Other treatment modalities
    • Conclusion
    • References
  • Resection of recurrent liver cancer
    W. Lamadé and Ch. Herfarth.
    • Tumor recurrence after resection of liver metastases
    • Interval between the resection of the primary tumor and liver metastases surgery
    • Interval between liver resection and recurrent liver metastases
    • Tumor spread at the time of liver metastases recurrence
    • Factors influencing the rate of recurrence
    • Perioperative effects on recurrence rates
    • Recurrence after repeat hepatic resection
    • Hepatic recurrence in patients with non-colorectal primary tumors
    • Surgical technique
    • Morbidity and mortality
    • Long-term survival after repeat resection of liver metastases
    • Prognostic criteria after first and second liver metastases resection
    • Conclusion
    • References
  • Repeat hepatectomy for primary liver cancer
    R. Adam, G. Marin-Hargreaves, D. Azoulay, D. Castaing, F. Meriggi, and H. Bismuth.
    • Introduction
    • Frequency of recurrence
    • Diagnosis of recurrence
    • Prevention of recurrence
    • Repeat liver resection
    • Conclusion
    • References
  • Percutaneous cryosurgery of irresectable liver tumors
    R. Adam, G. Marin Hargreaves, F. Meriggi, and H. Bismuth.
    • Introduction
    • History and principles
    • Cryosurgery technique
    • Specific aspects of percutaneous cryosurgery
    • Indications
    • Results
    • Complications
    • Conclusion
    • References
  • Liver transplantation
    I. M Sauer, W. O Bechstein, and P. Neuhaus.
    • Definition, indications and contraindications for liver transplantation
    • Preoperative evaluation
    • Operative technique in liver transplantation
    • Postoperative management
    • Comment
    • References
  • Portal hypertension
    John C Li and J.M. Henderson.
    • Historical perspective
    • Anatomy and physiology
    • Pathophysiology
    • Ascites
    • Budd-Chiari syndrome
    • References
  • Pyogenic and amebic liver abscess
    Iskender Sayek, M.D. and Demirali Onat, M.D.
    • Pyogenic abscess
    • Amebic liver abscess
    • References
  • Hydatid liver disease
    Jean-Luc Jourdan, M.D. and David L Morris, M.D.
    • Biology and epidemiology
    • Diagnosis
    • Treatment
    • Prevention
    • References
• Part VII. Biliary
  • Cholangiocarcinoma
    Bryan M Clary, William R Jarnagin, and Leslie H Blumgart.
    • Introduction
    • Demographics and Etiology
    • Pathology
    • Clinical Presentation and Diagnosis
    • Treatment
    • References
  • Klatskin tumors
    Keith D Lillemoe, M.D.
    • Definition, pathogenesis and epidemiology
    • Diagnosis and Staging
    • Surgical Treatment
    • Adjuvant therapy
    • Conclusion
    • References
  • Primary sclerosing cholangitis
    J. E J Krige, P. C Bornman, and J. Terblanche.
    • Definition
    • Incidence
    • Pathogenesis
    • Diagnosis
    • Clinical Presentation
    • Biochemical abnormalities
    • Cholangiography
    • Pathology
    • Medical therapy
    • Endoscopic treatment
    • Surgical treatment
    • Liver transplantation
    • Conclusion
    • References
  • Cholecystitis and Cholelithiasis
    René G Holzheimer.
    • Pathogenesis and prevalence
    • Indications and contra-indications for laparoscopic cholecystectomy
    • Laparoscopic cholecystectomy for acute cholecystitis
    • Conversion to open treatment
    • Randomized studies comparing open cholecystectomy and laparoscopic cholecystectomy
    • Randomized studies comparing mini-cholecystectomy with open cholecystectomy or laparoscopic cholecystectomy
    • Randomized studies comparing different techniques in pneumoperitoneum
    • Randomized studies in pain treatment and laparoscopic cholecystectomy
    • Common bile duct exploration and clearance - randomized studies
    • Antibiotic prophylaxis and laparoscopic cholecystectomy - randomized studies
    • Surgical technique and laparoscopic cholecystectomy - randomized studies
    • Summary
    • References
  • Acute cholangitis
    Chi-Leung Liu and Sheung-Tat Fan, M.D.
    • Introduction
    • Diagnosis
    • Management
    • Summary
    • References
  • Acute acalculous cholecystitis
    Philip S Barie, M.D.
    • Abstract
    • Introduction
    • Patterns of clinical illness
    • Pathogenesis
    • Diagnosis
    • Treatment
    • References
  • Laparoscopic biliary injury
    Raymond Aerts and Freddy Penninckx.
    • Mechanism and type of injury
    • Diagnosis
    • Treatment BTI at the time of laparoscopic cholecystectomy
    • Management of BTI diagnosed after laparoscopic cholecystectomy
    • Outcome
    • References
• Part VIII. Pancreas
  • Pancreatic cancer
    Dieter Birk and Hans G Beger.
    • Introduction
    • Epidemiology
    • Symptomatology and tumor biology
    • Diagnostic approach
    • Staging of pancreatic cancer
    • Indication for surgery and technical approach
    • Extended resection in pancreatic cancer
    • Prognostic factors ()
    • The role of surgery in the palliation of pancreatic cancer
    • Summary
    • References
  • Periampullary carcinoma
    L Fernandez-Cruz.
    • Definition
    • Epidemiology, clinical characteristics and diagnosis
    • Prognostic Factors
    • Staging
    • Surgery
    • Adjuvant Therapy
    • References
  • Cystic tumors of the pancreas
    Ramon E Jimenez, M.D., Carlos Fernandez-del Castillo, M.D., and Andrew L Warshaw, M.D.
    • Differential diagnosis
    • Tumor characteristics and treatment
    • References
  • Acute pancreatitis
    Pierre-Louis Fagniez and Nelly Rotman.
    • Acute pancreatitis
    • Etiology - pathogenesis
    • Diagnostic
    • Classification
    • Severity
    • Treatment
    • References
  • Early complications of severe acute pancreatitis
    C Bassi, M Falconi, G Butturini, and P Pederzoli.
    • Early complications
    • Early surgery
    • Biliary obstruction
    • Multi-organ failure (MOF), failure to improve, deterioration
    • Early infected necrosis
    • Hemorrhage and peritonitis
    • Extensive sterile necrosis
    • Rupture of Wirsung duct
    • Conclusion
    • References
  • Fistulas of the pancreas
    Roger Saadia, M.D.
    • Introduction
    • Pancreatico-cutaneous fistula
    • Pseudocysts
    • Pancreatic ascites and pleural effusions
    • Pancreatico-enteric fistula
    • References
• Part IX. Spleen and Lymphoproliferative Disease
  • Splenectomy for hematological disorders
    Selman Uranüs, M.D. and Heinz Sill, M.D.
    • Introduction
    • Splenectomy
    • References
  • Laparoscopic splenectomy for benign and malignant hematologic diseases
    Bertrand Millat, M.D. and Georges Decker, M.D.
    • Indications for LS
    • Operative techniques
    • Results of laparoscopic splenectomy
    • Conclusions
    • References
  • Lymphoma
    Alan M Yahanda, M.D.
    • Epidemiology and pathology
    • Surgery in the diagnosis of lymphoma
    • Staging laparotomy in Hodgkin's disease
    • Splenectomy in Non-Hodgkin's lymphoma
    • Summary
    • References
• Part X. Endocrine
  • Differentiated thyroid carcinoma
    O. Gimm and H. Dralle.
    • Definition, epidemiology and pathogenesis
    • Diagnosis
    • Surgical treatment
    • Primary therapy
    • Non-surgical treatment modalities
    • Conclusion
    • References
  • Sporadic and hereditary medullary carcinoma
    O. Gimm and H. Dralle.
    • Definition, epidemiology and pathogenesis
    • Diagnosis
    • Non-surgical treatment modalities
    • Surgical treatment
    • Conclusion
    • Acknowledgement
    • References
  • Thyroid carcinosarcoma and undifferentiated thyroid carcinoma
    S. Al-Sobhi and O. Clark.
    • Carcinosarcoma
    • Anaplastic Carcinoma
    • Lymphoma of the Thyroid Gland
    • References
  • Benign nodular thyroid disease
    René G Holzheimer, M.D.
    • Introduction
    • Definition, pathogenesis, and epidemiology
    • Diagnosis
    • Nontoxic uninodular thyroid disease
    • Nontoxic multinodular goiter
    • Toxic uninodular and multinodular goiter
    • Graves’ disease (M. Basedow)
    • Conclusion
    • References
  • Primary hyperparathyroidism
    G Åkerstrom and E Lundgren.
    • Definition, pathogenesis, and epidemiology
    • Symptoms
    • Diagnosis of HPT
    • Surgery
    • Non-operative surveillance
    • References
  • Parathyroid carcinoma
    Kerstin Sandelin.
    • Incidence
    • Diagnosis
    • Recurrent metastatic disease
    • Prognosis
    • Conclusion
    • References
  • Postoperative complications of parathyroidectomy
    J. R Farndon.
    • Infection
    • Hematoma
    • Skin tethering
    • Keloid formation
    • Hematoma
    • Recurrent nerve injury
    • Superior laryngeal nerve
    • Adenoma/disease not found
    • Persistent/recurrent disease
    • Wrong diagnosis/persistent disease
    • Hypocalcemia
    • Complications and informed consent
    • References
  • Laparoscopic adrenalectomy
    Stephen E Burpee, M.D., Gregg H Jossart, M.D., and Michel Gagner, M.D.
    • Indications
    • Contraindications
    • Results
    • References
  • Surgical management of adrenal neoplasms: laparoscopic versus open adrenalectomy
    Peter Y Wong, M.D. and Richard A Prinz, M.D.
    • Introduction
    • Conventional open methods for adrenalectomy
    • The flank or posterior approach
    • The anterior or transabdominal approach
    • The transthoracic or thoracoabdominal approach
    • The lateral transperitoneal or flank laparoscopic approach
    • The anterior laparoscopic approach
    • The posterior or retroperitoneal laparoscopic approach
    • Laparoscopic versus open adrenalectomy
    • References
  • Pheochromocytoma
    Nader N Hanna, M.D. and Daniel E Kenady, M.D.
    • Definition, origin, and epidemiology
    • Extra-adrenal pheochromocytomas
    • Familial and hereditary pheochromocytomas
    • Pathophysiology and symptomatology
    • Biochemical diagnosis
    • Pharmacological tests
    • Localization
    • Pre-operative management
    • Surgical management
    • Surgical approaches
    • Anesthetic and intraoperative considerations
    • Surgical outcome and post-operative follow-up
    • Malignant pheochromocytomas
    • Pheochromocytoma in pregnancy
    • Conclusion
    • References
  • Endocrine tumors of the pancreas
    François Pattou, M.D. and Charles Proye, M.D.
    • Introduction
    • Pathology
    • Symptom recognition
    • Confirm the diagnosis
    • Ruling out a genetic setting
    • Localization of the tumors
    • Treatment
    • Surgical strategy
    • Advanced disease
    • References
  • Gastrinoma
    Robert T Jensen.
    • Introduction, history and definition
    • Epidemiology
    • Clinical features ()
    • Diagnosis and differential diagnosis
    • Pathology, tumor biology and pathogenesis
    • Management
    • Prognosis
    • References
  • Neuroendocrine tumors metastatic to the liver
    Ingemar Ihse, M.D., Gert Lindell, M.D., and Sten Tibblin, M.D.
    • Primary tumors and frequency of neuroendocrine liver metastases
    • Diagnosis
    • Surgical management
    • Ischemic therapy, embolization, chemoembolization
    • Medical therapy
    • Management of non-functioning pancreatic endocrine tumors
    • References
  • Small bowel neuroendocrine tumors
    G. Åkerström and P. Hellman.
    • Definition and incidence
    • Morphologic features
    • Clinical presentation
    • Diagnosis
    • Surgery of the mesenterico-intestinal lesion
    • Medical treatment
    • Treatment of liver metastases
    • Survival and life quality
    • References
• Part XI. Soft tissue tumors and melanoma
  • Soft tissue sarcoma
    David C Linehan and Murray F Brennan.
    • Introduction
    • Etiology, epidemiology and genetics
    • Pathology, clinical presentation and staging
    • Treatment of localized STS
    • Treatment of local recurrence
    • Surgical treatment of metastatic STS
    • Summary
    • Reference List
  • Malignant of melanoma
    Paul L Baron and Christophe L Nguyen.
    • Background
    • Microstaging
    • Conclusion
    • References
  • Isolated limb perfusion for malignant melanoma
    Hiram C Polk Jr., M.D. and Michael J Edwards, M.D.
    • Introduction
    • Melanoma prognosis and therapy
    • Perfusion technique
    • Patient selection
    • Collective studies
    • Summary
    • References
  • Adjuvant therapy of malignant melanoma
    Prof. Alexander M M Eggermont, M.D.
    • Adjuvant surgical procedures in the management of primary melanoma
    • Systemic adjuvant therapy
    • Adjuvant IFNα trials
    • Conclusions
    • References
• Part XII. Miscellaneous
  • Carcinoma of the lung
    J. L Balibrea, A. J Torres, and J. Arias-Diaz.
    • Risk factors
    • Pathology
    • Stage
    • Prevention
    • Non-small-cell lung cancer (NSCLC)
    • Small-cell lung cancer
    • References
  • Thoracoscopic pulmonary surgery
    T. Hau and E. Förster.
    • Trauma
    • Pleural empyema
    • Recurrent or persistant pneumothorax
    • Pulmonary resection
    • Thoracoscopy in cancer patients
    • Surgical treatment of pulmonary emphysema
    • References
  • Carcinoma of the breast
    Gordon F Schwartz, M.D.
    • Introduction
    • Diagnosis
    • Staging
    • Treatment
    • In situ lobular carcinoma (LCIS)
    • In situ ductal carcinoma (DCIS)
    • Clinical stages I and II invasive carcinoma
    • Adjuvant therapy
    • Clinical stage III (A and B) invasive carcinoma
    • Post-mastectomy radiation therapy
    • Clinical stage IV carcinoma
    • Management of local recurrence following breast conservation
    • Male breast cancer
    • Follow-up of the breast cancer patient
    • References
  • Sentinel node detection
    A. Bembenek, M.D. and P.M. Schlag, M.D.
    • Definition
    • Technique
    • Influence of particle size
    • Examination of the SN
    • SN in melanoma patients
    • Current technique of the SN-biopsy in melanoma
    • Clinical application
    • SN in breast cancer patients
    • Internal mammary lymph nodes
    • Clinical application
    • Further application of the SN-concept
    • Conclusion
    • References
  • Complications of laparoscopic surgery
    Richard A Perugini, M.D. and Mark P Callery, M.D.
    • Complications of laparoscopic access
    • Physiologic complications of pneumoperitoneum
    • Complications of operative procedure
    • Conclusions
    • References
  • Intra-operative and laparoscopic ultrasound
    Bruce David Schirmer, M.D.
    • Abstract
    • Equipment and technique
    • Summary
    • References
• Part XIII. Abdominal wall
  • Hernias
    Joachim Conze, Uwe Klinge, and V. Schumpelick.
    • Definition
    • History
    • Pathogenesis
    • Epidemiology
    • Diagnosis
    • Classification
    • Symptoms and Complications
    • Surgical Procedures
    • Inguinal Hernia in Adults
    • Inguinal Hernia in Children
    • Femoral Hernia
    • Epigastric Hernia
    • Umbilical Hernia
    • Spieghelian Hernia
    • Obturator Hernia
    • Perineal Hernia
    • Incisional or Recurrent Hernia
    • References
  • Management of the difficult abdominal closure
    Anna M Ledgerwood, M.D.
    • Types of wound closures
    • Abdominal wall pack technique
    • Bilateral advancement muscle flap technique
    • References
  • Abdominal wall considerations in re-operative surgery
    D. E Fry.
    • Definitions, pathogenesis, and epidemiology
    • Diagnosis
    • Prevention
    • Management of abdominal wound complications
    • References
• Part XIV. Trauma
  • Liver trauma
    Karen J Brasel, M.D. and Anthony A Meyer, M.D.
    • Settled controversy: management choice for blunt hepatic injury
    • Current controversies: role of angiography and management of penetrating injuries
    • References
  • Pancreatic, splenic and duodenal injuries
    Ken Boffard and Adam Brooks.
    • Introduction
    • Pancreatic injury
    • Duodenal injury
    • Complications
    • Summary
    • Splenic injury
    • Summary
    • References
  • Colon injuries
    C. G Rehm and D. D Trunkey.
    • Diagnosis
    • Management
    • Technique of exploration
    • Direct wound management options
    • Conclusion
    • References
  • Damage control
    Jon M Burch, M.D. and Ernest E Moore, M.D.
    • Results
    • References
• Part XV. Surgical Infections
  • Soft tissue infections
    R.T. Lewis.
    • Introduction
    • Presentation and pathogenesis
    • Necrotizing focal infections
    • Toxic non-necrotizing focal infections
    • Diffuse non-necrotizing infection: cellulitis
    • Diffuse necrotizing cellulitis
    • Diagnosis
    • Treatment
    • References
  • Necrotizing soft-tissue infections
    Thomas L Bosshardt, M.D., Vernon J Henderson, M.D, and Claude H Organ Jr, M.D.
    • Presentation and diagnosis
    • Bacteriology
    • Treatment
    • Mortality
    • Summary
    • References
  • Diabetic foot infections
    Charles A Adams Jr., M.D. and Edwin A Deitch, M.D.
    • Definition, pathogenesis, and epidemiology
    • Diagnosis
    • Antibiotic therapy
    • Non-surgical treatments
    • Surgical treatment
    • Conclusion
    • References
  • Wounds in infection and sepsis - role of growth factors and mediators
    David T Efron, M.D. and Adrian Barbul, M.D.
    • Phases of normal healing
    • Role of growth factors in normal healing
    • Impaired healing in sepsis
    • Surgical site infection
    • Current clinical strategies for growth factor therapy
    • Conclusion
    • References
  • Burn wound infections
    LC Cancio, M.D., PA Howard, M.D., AT McManus, SH Kim, M.D., CW Goodwin, M.D., and BA Pruitt Jr., M.D.
    • Introduction
    • Invasive burn wound infection
    • Invasive infection of excised wounds, donor sites, and grafted wounds
    • Burn wound cellulitis
    • Burn wound impetigo
    • Conclusions
    • Acknowledgments
    • References
  • Current therapy of burns
    Arthur P Sanford, M.D. and David N Herndon, M.D.
    • Conclusion
    • References
  • Management of secondary peritonitis
    René G Holzheimer.
    • Definition, pathogenesis, and epidemiology
    • Conclusion
    • References
  • Management of intra-abdominal abscesses
    M. Schein.
    • Definition and significance
    • Classification & pathogenesis
    • Microbiology
    • Clinical features
    • Diagnosis
    • Treatment
    • Conservative treatment
    • Drainage
    • Surgical management of intra-abdominal abscesses
    • Conclusions
    • References
  • The abdomen as a source of sepsis in critically ill patient
    Ronald C Merrell, M.D. and Rifat Latifi, M.D.
    • Anatomy of intra-abdominal sepsis
    • Diagnostic approach to patient with expected abdominal sepsis
    • Patient with secondary dependent pathology
    • Patient with secondary independent pathology
    • Treatment options of intra-abdominal pathology in critically ill patients
    • Summary
    • References
  • Bloodstream and intravascular catheter infections
    Kelli M Bullard, M.D. and David L Dunn, M.D.
    • Sepsis syndrome
    • Gram-negative bacteremia
    • Gram-positive bacteremia
    • Fungemia
    • Intravascular catheter infection
    • Summary
    • References
  • Antibiotic prophylaxis
    René G Holzheimer.
    • Epidemiology
    • Pathogenesis
    • Classification and Risk factors
    • Selection of antibiotics
    • Recommendation for specific procedures ()
    • References
  • Antibiotics in surgery: evidence of anecdote?
    John M A Bohnen, M.D.
    • Conclusion
    • References
• Part XVI. Surgical critical care issues
  • Cardiopulmonary resuscitation
    Robert K Goldman, M.D. and Donald Trunkey, M.D.
    • Definition, pathogenesis, and epidemiology
    • Diagnosis
    • Therapy
    • Conclusion
    • References
  • Hemodynamic monitoring
    Christian Kuhn and Karl Werdan.
    • Goals of monitoring
    • Physiological basis of cardiac monitoring
    • Contractility
    • Monitoring techniques
    • References
  • ARDS
    Lothar Engelmann, M.D.
    • Definition
    • Pathogenesis
    • Epidemiology and prognosis
    • Diagnosis
    • Management
    • Conclusion
    • References
  • Catecholamines and acute renal failure
    John A Kellum, M.D.
    • Introduction
    • Definitions, pathophysiology and epidemiology
    • Dopamine and related agents
    • Other catecholamines
    • Conclusions and recommendations
    • References
  • Hepatocellular dysfunction–basic considerations
    Doraid Jarrar, M.D., Ping Wang, M.D., and Irshad H Chaudry, Ph.D.
    • Introduction
    • Alterations in hepatocellular function following trauma and hemorrhage
    • Summary
    • References
  • Monitoring of the hepatosplanchnic region
    Karl Träger, Alexander Brinkmann, and Peter Radermacher.
    • Introduction
    • Measurement of splanchnic blood flow, oxygen transport
    • Measurement of regional PCO₂
    • Measurement of hepatosplanchnic metabolism
    • Summary
    • References
  • Prophylaxis and management of stress ulceration
    Avery B Nathens, M.D. and Ronald V Maier, M.D.
    • Epidemiology
    • Pathogenesis
    • Prophylaxis
    • Management
    • References
  • The multiple organ dysfunction syndrome
    John C Marshall, M.D.
    • MODS: Clinical and pathologic description
    • Prevention of MODS
    • Conclusion
    • References
  • The immunocompromised patient
    Philip S Barie, M.D.
    • Adrenal insufficiency
    • Diabetes mellitus
    • Febrile neutropenia
    • Human immunodeficiency virus infection
    • References
  • Laparotomy for abdominal sepsis in the critically ill
    Christian H Wakefield and Kenneth C H Fearon.
    • Introduction
    • Demographics of intra-abdominal sepsis
    • Surgical approaches and treatment goals
    • Expectations of re-laparotomy
    • Conclusion
    • References
  • Abdominal compartment syndrome
    Bob H Saggi, M.D., Rao Ivatury, M.D., and Harvey J Sugerman, M.D.
    • Introduction
    • Historical background
    • Recognition of ACS
    • Pathophysiology
    • Clinical management
    • Summary
    • References
  • Analgesia and sedation in critically ill patients
    Daniel R Brown, M.D. and Michael J Murray, M.D.
    • Introduction
    • Analgesia
    • Sedation
    • Summary
    • References
  • Assessment of coagulation in surgical critical care patients
    Ian D McGilvray, M.D. and Ori D Rotstein, M.D.
    • Abstract
    • Introduction
    • The coagulation cascade
    • Counter-regulation of coagulation
    • Contribution of the coagulation cascade to the local and systemic inflammatory response
    • The surgical critically ill patient: a procoagulant condition
    • Diagnostic tests of coagulation
    • Coagulation issues in critical care patients
    • Overview: Assessment of coagulation in the critically ill surgical patient
    • Conclusions
    • References
  • Methicillin-resistant staphylococcus aureus
    M. S Ibelings and H. A Bruining.
  • Candida infections in surgical intensive care unit patients
    Jean-Louis Vincent.
    • Introduction
    • Epidemiology and pathogenesis
    • Diagnosis
    • Therapy
    • Conclusion
    • References
  • Ethical considerations
    WI Karen J Brasel, M.D.H. and Anthony A Meyer, M.D.
    • Does the presence or type of hospital DNR policy influence DNR orders or discussions about limiting care in any way?
    • Does the presence of a DNR order influence resource use or nursing care?
    • Can education change physician practices regarding end of life decisions?
    • Do patients want to discuss DNR preferences?
    • References
  • Nitric oxide in trauma and sepsis
    C. Hierholzer and T. R Billiar.
    • Summary
    • NO production
    • Molecular targets
    • Cytoprotection, cytotoxicity
    • Hemorrhagic shock
    • Sepsis
    • Therapeutic interventions
    • Conclusions
    • References
• Appendix