Clinical Surgery

4th Edition - November 29, 2022
Editors: M. Asif Chaudry, James Kinross, Shahnawaz Rasheed
Language: English
Paperback ISBN:
9 7 8 - 0 - 7 0 2 0 - 7 0 5 0 - 1
eBook ISBN:
9 7 8 - 0 - 7 0 2 0 - 7 0 5 2 - 5

Clinical Surgery provides a complete overview of all surgical specialties, and is suitable for advanced undergraduates through to surgical trainees preparing for the FRCS. Thi… Read more

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Clinical Surgery provides a complete overview of all surgical specialties, and is suitable for advanced undergraduates through to surgical trainees preparing for the FRCS.

This comprehensive textbook is designed around the Intercollegiate Surgical Curriculum Programme (ISCP) framework, and provides information needed for passing MCQs, OSCEs and Vivas in the one book. Information is divided into three clear sections: basic science and surgical strategy; common surgical conditions and trauma; and leadership, evidence-based practice and global surgery.

This fourth edition has been fully updated and restructured by a new editorial team. Older concepts have been replaced by a new focus on systems biology, omics sciences and multidisciplinary sciences, and the book presents a modern, inclusive view of the surgeon as part of a multidisciplinary team delivering high quality care.

Cover image
Title page
Table of Contents
Copyright
Foreword
List of Contributors
Abbreviations
Section 1. General Issues
1. Inflammation, Wound Healing and Surgical Immunology
Wounds
Anatomy and Physiology of the Skin
Wound Healing
Factors Involved in Wound Healing1,7
Acute Wounds
Chronic Wounds
Acute Wound Management
Wound Closure
Dressings1,6
Summary
2. Pharmacology in Surgical Practice
Safe Prescribing
A Basic Introduction to Pharmacology
Commonly Used Drugs in Surgical Practice
Common Analgesics
Drugs Used in General Anaesthesia
Local Anaesthesia
Epidural and Spinal Anaesthesia
Antibiotics
Anticoagulants
Pharmacological Principles for Treatment of Malignancy
Summary
3. Disorders of Growth, Differentiation and Morphogenesis
Introduction
Growth
Control of Growth
Disorders of Growth
Differentiation
Morphogenesis
Disorders of Growth, Differentiation and Morphogenesis During Embryogenesis
4. Cancer: Principles of Surgical Oncology
Introduction
The Presentation of Cancer
Carcinogenesis and Growth
Influence of Biology on Clinical Course
Invasion and Metastasis
Cancer Staging
Cancer Biomarkers
Decision Support Tools
Centralization of Cancer Services in Surgery and Cancer Strategy
Principles of Curative Oncological Surgery
Definitive or Palliative Systemic Therapy
Survivorship
Summary
5. Surgical Infection
Infection in General
Diagnosis and Management of Infection
Important Infections in Surgical Patients
6. Health Promotion and Disease Prevention
Introduction
Key Modifiable Risk Factors for Long-Term Conditions
Obesity
Physical Activity
Alcohol
Diet and Nutrition
Illicit Drugs
Mental Health
Standards for Health Promotion in Hospitals
Summary
7. The Principles of Assessment and Management of the Surgical Patient
Physiological Basis of Surgical Care
Normal Gastrointestinal Physiology
Features of Preoperative Assessment
The Postoperative Period
Postoperative Complications
Summary
8. Perioperative Management and Postoperative Complications
Preoperative Assessment
Preoperative Assessment
Medications Review and Recommendations
Investigations
The High-Risk Patient
The Elderly Patient
Assessing Risk
Shared Decision Making and the Multidisciplinary Team
Intraoperative Management
Anticipated Critical Events
Surgical Site Infection Bundle
Postoperative Management
Routine Postoperative Care
Postoperative Complications and the Unwell Surgical Patient
Considerations for Discharge
9. Principles of Paediatric Surgery
General Principles
Surgical Pathology in Children
Conditions Presenting with Respiratory Distress
The Newborn with Intestinal Obstruction
Congenital Abdominal Wall Defects
Disorders of the Umbilicus
The Inguinal Region
Common Abdominal Masses in Children
Tumours and the Paediatric Surgeon
Disorders of Genitalia
Principles of Paediatric Trauma
10. The Older Surgical Patient
Introduction
Determining Surgical Risk
Communicating Surgical Risk
Improving Surgical Outcomes
Anaesthesia in the Older Person
Analgesia in the Older Person
Trauma in the Older Person
Perioperative Service Delivery for Complex Patients
Summary and Conclusions
11. The Dying Surgical Patient
How Do I Review a Dying Patient?
Considerations and Questions That Arise at the End of Life
The Family Says ‘How Long Has my Relative Got’ (and Variations of That Question)?
What PRNs Do I Prescribe for a Dying Patient?
When Do I Start a Syringe Driver?
Should I Continue I.V. Fluids?
When Should I Contact the Coroner’s Office (England and Wales)?
12. Organ Transplantation
Organ Transplantation
Essential Definitions
Organ Donation
Donation After Brain Death (DBD)
Donation After Circulatory Death (DCD)
Allocation of Organs
Living Donor
Basic Immunology of Organ Transplantation
Organ Matching and Retrieval
Immunosuppression in Transplantation
General Complications of Transplantation
Pattern of Infection After Transplantation
Transplantation of Individual Organs
Transplantation in Children
The Future
13. Emergency General Surgery
Introduction
Epidemiology of Emergency General Surgery
The Modern Emergency Surgical Team
NCEPOD
The Medical Emergency
Preoperative Work-Up of Emergency Surgery Patients
Anaesthetic Assessment and Perioperative Care
Preoperative Risk Assessment
Coagulation and DVT Prophylaxis
Human Factors in Emergency Surgery
Pathology Presenting to the Emergency Surgeon
Laparoscopy in Emergency Surgery
The Patient with Peritonitis
Acute Appendicitis
Acute Upper GI Bleeding
Peptic ulcer
Bleeding Oesophageal Varices
Gastric Erosion (Stress Ulceration)
Incomplete Lower Oesophageal Tear (Mallory–Weiss Syndrome)
Dieulafoy’s Lesion
Rarer Causes of Haematemesis
The Obstructed Patient
Operative Strategies
GI Bleeding
Abscesses
14. Practical Procedures
Introduction
Preliminaries
VENOUS ACCESS
Venepuncture
Venous Cut-Down
Central Venous Catheterization
Arterial Blood Sampling
INSERTION OF A NASOGASTRIC TUBE
URINARY CATHETERIZATION
Male Catheterization (Fig. 14.13)
Female Catheterization
Suprapubic Bladder Drainage
CHEST PROCEDURES
Relief of Tension Pneumothorax
Insertion of a Chest Drain
Pericardial Paracentesis
PERITONEAL LAVAGE
AIRWAY MANAGEMENT
Surgical Airway
THE BASICS OF ELECTROSURGERY
Surgical Effects
Monopolar Electrosurgery Safety
Vessel Sealing
Plasma Electrosurgery
Training and Credentialing
15. An Introduction to Radiology and Diagnostic Imaging
Introduction
Radiography
Radio-Opaque Contrast
Nuclear Medicine
Sonography
Magnetic Resonance Imaging
Artificial Intelligence and the Future of Radiology
16. Interventional Radiology
Introduction
The Interventional Radiology Department
General Principles of IR
Subspecialist IR Procedures
17. Surgical Technology and Innovation
Introduction
Medical Devices in Surgery
Minimally Invasive and Robotic Surgery
Technological Advances in Surgical Education
Summary and Future Considerations
Section 2. Regional Surgery
18. Common Surgical Conditions of Head and Neck
The Ear
The Nose
The Larynx
The Pharynx
The Neck
The Salivary Glands
Thyroid and Parathyroid Glands
Genetically Inherited Conditions in Otolaryngology
19. Common Surgical Conditions of Pulmonary Disease
Anatomy of the Thorax
Lung Cancer
Other Lung Tumours
Principles of Chest Drainage
Pneumothorax
Chest Trauma and Haemoptysis
The Pleura
The Mediastinum
Surgery for Emphysema – Lung-Volume–Reduction Surgery (LVRS)
Transplantation
20. Common Upper Gastrointestinal Surgical Conditions and their Management
Oesophagus
Disorders of Oesophageal Motility
Cancer of the Oesophagus
Stomach
Disorders of the Stomach and their Management
Gastric Cancer
Gastrointestinal Stromal Tumours (GISTs)
Spleen
Disorders of the Spleen and their Management
Traumatic Splenic Injury
Splenectomy
21. Common Colorectal Surgical Conditions
Anatomy
Physiology
Benign Colorectal Disease
Rectal Prolapse (see Ch. 22)
Inflammatory Bowel Disease
Complications
Crohn’s Disease of the Colon
Ischaemic Colitis
Infective Diseases
Radiation Colitis and Proctitis
Neoplasia
Malignant Neoplasms
22. Common Anal Conditions
Anatomy
Haemorrhoids
Anorectal Abscess
Fistula in Ano
Anal Fissure
Rectal Prolapse
Anal Warts (Condyloma Acuminata)
Pruritus Ani
Faecal Incontinence
23. Surgical Pathology of the Liver, Pancreas and Biliary Tract
The Liver
Jaundice
Benign Conditions of the Liver
Liver Trauma
Liver Infections
Liver Tumours
Malignant Tumours
Intrahepatic Cholangiocarcinoma
Metastatic Cancer to the Liver
Gallstones (Cholelithiasis)
Stones in the Gallbladder
Common Bile Duct Stones (Choledocholithiasis)
Stones in the Small Intestine
Sphincter of Oddi Dysfunction
Gallbladder Tumours
Cholangiocarcinoma
Pancreas
Pancreatitis
24. Small-Bowel Disease and Intestinal Obstruction
Introduction
Anatomy
Physiology
Intestinal Obstruction
Causes of Mechanical Bowel Obstruction
Tuberculosis
Radiotherapy Effects
Diverticula of the Small Bowel
Small-Bowel Tumours
25. Common Endocrine Surgical Conditions
Introduction
Thyroid
Anatomy
Physiology
Diseases Influencing the Thyroid
Evaluation of Thyroid Disease
Thyrotoxicosis
Thyroid Cancer
Parathyroid Transplantation
Thyroiditis
Parathyroid
Histology
Physiology
Parathyroid Hormone
Hyperparathyroidism
Adrenal Glands
Physiology
Adrenal Cortex
Hyperaldosteronism
Phaeochromocytoma and Paraganglioma
Neuroblastoma
Gastroenteropancreatic Neuroendocrine Tumours (GEP-NET)
Pancreatic Endocrine Tumours
Intestinal NET
Multiple Endocrine Neoplasia
Anterior Pituitary Tumours
26. Common Breast Surgical Conditions
Clinical Anatomy
Referral
The One-Stop-Clinic
Benign Breast Disease (B1 and B2)
B3 Lesions
Ductal Carcinoma-In-Situ
Malignant Breast Disease
27. Common Vascular Conditions
Vascular Surgery
Pathological Features of Arterial Disease
Techniques
Chronic Lower-Limb Ischaemia
Critical Limb Ischaemia or Chronic Limb-Threatening Ischaemia
Arterial Disorders of the Upper Limb
Acute Ischaemia of A Limb
Vasospastic Disorders (Raynaud’s Phenomenon)
Cerebrovascular Disease
Visceral Ischaemia
Renal Artery Disease
Vascular Trauma
Arteriovenous Malformation
Venous and Lymphatic Disorders
Lymphatic Disorders
Future Directions
28. Common Urological Conditions
Introduction
Kidneys and Ureters
Disorders of the Kidney
Disorders of the Ureter
The Lower Urinary Tract
Disorders and Disease of the Bladder
The Prostate
The Male Urethra
Penis
Testis, Epididymis and Cord
Scrotal Swellings
Andrology
29. Common Neurosurgical Conditions
Basic Clinical Principles
Cranial and Spinal Trauma
Tumours of the Brain and Meninges
Cerebral Haemorrhage and Stroke
Congenital Anomalies and Paediatric Neurosurgery
Hydrocephalus
Spinal Degenerative Disease
Spinal Tumours
Peripheral Nerve Lesions
Infections
Functional Neurosurgery
30. Hernia
General Considerations
Specific Hernias
Femoral Hernia
Umbilical Hernia
Epigastric Hernia
Incisional Hernia
Rare but Clinically Important Hernias
31. Principles of Plastic Surgery
Plastic Surgery Techniques
Wound Healing
Skin Grafts
Other Types of Graft Materials
Prostheses
Flaps
Free Tissue Transfer
Tissue Expansion
Common Reconstructive Referrals
32. Skin Disorders
Introduction
Disorders of the Skin
Infections
Viral Infections
Bacterial Infections
Fungal Infections
Tumours
Benign Tumours of the Epidermis
Other Benign Skin Tumours
Premalignant Conditions of the Epidermis
Non-Melanoma Skin Cancer
Malignant Melanoma (syn. Melanoma)
Malignant Tumours of the Dermis
Other Malignancies of the Skin
33. Sarcoma
Introduction
Classification
Clinical History
Pathogenesis
Examination
Age
Distribution
Mode of Metastatic Spread
Radiology
Biopsy
Pathology
Grading
Staging
Treatment
Treatment of Systemic Disease
GIST
Prognosis
34. Bariatric and Metabolic Surgery
Introduction
Epidemiology
Therapeutic Options of Obesity
Indications for Surgery
Selection for Surgery
Surgical Procedures
Effects of Surgery
Risk Stratification
Postoperative Complications
Weight Regain
Procedure-Specific Complications
Social and Lifestyle Considerations
Revision Surgery
Summary
35. Trauma and Orthopaedic Surgery
Special Features of Orthopaedic History and Examination
Arthritis
Infections
Bone Tumours
Shoulder
Acromioclavicular Disorders
Subacromial Disorders
Glenohumeral Disorders
Elbow
Hand and Wrist
Hip
Knee
Ankle and Foot
Foot
Paediatric orthopaedics
Talipes
Minor Leg Deformities
36. Trauma Surgery/Principles of Trauma Care
Introduction
Emergency Department Surgery
Damage Control
Vascular Trauma
Specific Injuries
Head and Neck Surgery
Airway Control and Breathing Support in Maxillofacial Trauma
Head and Neck Trauma Surgery
Vision Threatening Injuries
Management of Facial Fractures
Head Trauma
Extremity and Soft Tissue Trauma
Principles of Trauma Care to The Solid Organs of the Thorax and Abdomen
Hollow Organ Injuries
Urogenital Trauma
Advanced Trauma/Military Surgery
Management of Gunshot Wounds
Blast Injuries
Section 3. Surgical Specialties
37. Leadership and the Surgical Team and Management
Strong Surgical Leadership for Future
The Definition of Leadership
Leadership and Management
The Evolution of Leadership Theory
Effective Leadership in Surgery
Leadership and Safety
Training in Leadership
Mentoring and Coaching
Conclusion
38. Evidence Based Medicine
History and Development
Evidence Based Medicine: Principles of Evidence
Searching for Evidence
Tools for Evidence Synthesis
Comparative Effectiveness
Implementing Evidence Based Medicine
Evidence Based Medicine and Quality of Care
Technology, Innovation and Diffusion of Ideas
39. Surgical Ethics
Introduction
Evolution of Surgery and Ethics
DNACPR
Summary
40. Global Surgery
Introduction
Surgical Conditions
Plastic Surgery
Paediatric Surgery
Ophthalmology
Dental
Index

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M. Asif Chaudry