Current Surgical Therapy

14th Edition - November 16, 2022
Imprint: Elsevier
Editors: John L. Cameron, Andrew M. Cameron
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 6 8 3 - 5
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 6 8 4 - 2

An essential resource for written, oral, and recertifying board study, as well as an excellent reference for everyday clinical practice, Current Surgical Therapy, 14th Edition,… Read more

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An essential resource for written, oral, and recertifying board study, as well as an excellent reference for everyday clinical practice, Current Surgical Therapy, 14th Edition, provides trusted, authoritative advice on today's best treatment and management options for general surgery. Residents and practitioners alike appreciate the concise, highly formatted approach to each topic, as well as the practical, hands-on advice on selecting and implementing current surgical approaches from today’s preeminent general surgeons. This highly regarded text remains the only surgical reference of its kind, offering a complete array of topics and delivering just the key facts.

Cover Image
Title Page
Copyright
Contributors
Preface
Table of Contents
Video Contents
The American Board of Surgery Certifying (Oral) Examination
The American Board of Surgery Certifying (Oral) Examination
PRINCIPLE
CONTENT
PROCESS
PREPARATION
ASSESSMENT
SUMMARY
SUGGESTED READINGS
Esophagus
Esophageal Function Tests
ESOPHAGEAL MANOMETRY
ESOPHAGEAL pH MONITORING
IMPEDANCE TESTING
FUNCTIONAL LUMINAL IMAGING PROBE PANOMETRY
CONCLUSION
SUGGESTED READINGS
Surgical Management of Gastroesophageal Reflux Disease
PRESENTATIONS OF GERD
DIAGNOSIS AND PREOPERATIVE EVALUATION
INITIAL MANAGEMENT AND INDICATIONS FOR SURGERY
SURGICAL TECHNIQUE
POSTOPERATIVE CARE, SURGICAL COMPLICATIONS, AND OUTCOMES
SPECIAL CONSIDERATIONS
SUGGESTED READINGS
New Approaches to Gastroesophageal Reflux Disease (Linx)
WHY A NEW SURGICAL ANTIREFLUX PROCEDURE?
NEW SURGICAL APPROACH TO GERD
LINX ANTIREFLUX DEVICE
LINX IMPLANTATION PROCEDURE
LONG-TERM CLINICAL OUTCOMES OF THE LINX MAGNETIC SPHINCTER AUGMENTATION DEVICE
SUGGESTED READINGS
Management of Barrett’s Esophagus
DEFINITION OF BARRETT’S ESOPHAGUS AND TREATMENT OBJECTIVES
CLINICAL EFFECT AND FEATURES OF BARRETT’S ESOPHAGUS
SCREENING AND EVALUATION OF BARRETT’S ESOPHAGUS
SURVEILLANCE
MANAGEMENT OF BARRETT’S ESOPHAGUS WITHOUT DYSPLASIA
MANAGEMENT OF BARRETT’S ESOPHAGUS WITH LOW-GRADE DYSPLASIA
MANAGEMENT OF BARRETT’S ESOPHAGUS WITH HIGH-GRADE DYSPLASIA
CONSIDERATIONS REGARDING ANTIREFLUX SURGERY IN BARRETT’S ESOPHAGUS
CONCLUSION
SUGGESTED READINGS
Endoscopic Treatment of Barrett’s Esophagus
SURVEILLANCE AND MANAGEMENT ALGORITHM
PRINCIPLES OF ENDOSCOPIC THERAPIES
ENDOSCOPIC RESECTION TECHNIQUES
ENDOSCOPIC ABLATION TECHNIQUE
CONCLUSION
SUGGESTED READINGS
Management of Paraesophageal Hernia Repair
SURGICAL INDICATIONS AND PREOPERATIVE EVALUATION
SURGICAL TECHNIQUE
POSTOPERATIVE CARE
OUTCOMES
Acknowledgments
SUGGESTED READINGS
Management of Zenker’s Diverticulum
GENERAL CONSIDERATIONS
PATHOPHYSIOLOGY
DIAGNOSIS
TREATMENT
SURGICAL MANAGEMENT
ENDOSCOPIC TREATMENT OF ZENKER’S DIVERTICULUM
SUGGESTED READINGS
Achalasia of the Esophagus
TREATMENT
TREATMENT FAILURE, ADVANCED DISEASE, AND FOLLOW-UP
SUMMARY
SUGGESTED READINGS
Management of Disorders of Esophageal Motility
PRESENTATION
CONCLUSION
Acknowledgment
SUGGESTED READINGS
Management of Esophageal Cancer
EPIDEMIOLOGY
CLINICAL PRESENTATION
DIAGNOSIS/STAGING
STAGE-BASED TREATMENT STRATEGIES/ALGORITHMS
OPERATIVE APPROACHES TO ESOPHAGEAL CANCER
COMPLICATIONS
CONCLUSION
SUGGESTED READINGS
Multimodality Therapy in Esophageal Cancer
OVERVIEW
DEFINITIONS OF MULTIMODAL THERAPY AND INDICATIONS IN ESOPHAGEAL CANCER
CONCLUSIONS
SUGGESTED READINGS
Use of Esophageal Stents
STENTS THROUGH THE AGES
STENT SELECTION
PATIENT SELECTION
INDICATIONS
PROCEDURE
COMPLICATIONS
CONCLUSION
SUGGESTED READINGS
Management of Esophageal Perforation
INTRODUCTION
DIAGNOSIS
MANAGEMENT
SUGGESTED READINGS
Stomach
Benign Gastric Ulcer
TYPES OF BENIGN GASTRIC ULCER
SURGICAL OPTIONS FOR GASTRIC ULCER
INDICATIONS FOR OPERATION
PERFORATED GASTRIC ULCER
BLEEDING GASTRIC ULCER
OBSTRUCTING GASTRIC ULCER
NONHEALING GASTRIC ULCER (INTRACTABILITY)
MARGINAL AND RECURRENT ULCER
SUGGESTED READINGS
Management of Duodenal Ulcers
INTRODUCTION
MEDICAL MANAGEMENT OF DUODENAL ULCER
BLEEDING DUODENAL ULCER
GASTRIC OUTLET OBSTRUCTION
INTRACTABLE DUODENAL ULCER
MANAGEMENT OF THE DIFFICULT DUODENAL STUMP
CONCLUSION
SUGGESTED READINGS
Management of Zollinger-Ellison Syndrome
CLINICAL PRESENTATION
CLINICAL PATHOLOGIC CORRELATION
DIAGNOSIS
TUMOR LOCALIZATION
SURGICAL MANAGEMENT OF GASTRINOMA
SURGERY FOR ZOLLINGER-ELLISON SYNDROME
SURGICAL EXPLORATION AND RESECTION TECHNIQUES
SUMMARY
SUGGESTED READINGS
Management of Mallory-Weiss Syndrome
PATHOPHYSIOLOGY AND RISK FACTORS FOR MWT
DIAGNOSIS
TREATMENTS FOR MWT: ENDOSCOPY, ANGIOGRAPHY, AND SURGERY
SUMMARY
SUGGESTED READINGS
Management of Gastric Adenocarcinoma
INTRODUCTION
RISK FACTORS
PATHOLOGY
DIAGNOSIS AND STAGING
SURGERY
POSTOPERATIVE RECOVERY
SYSTEMIC THERAPY
TARGETED THERAPY
SURVEILLANCE
PALLIATION
CONCLUSION
SUGGESTED READINGS
Familial Gastric Cancer
PATHOLOGY OF GASTRIC CANCER
PREOPERATIVE WORKUP AND SURGICAL INTERVENTION
POSTSURGICAL CARE
SUGGESTED READINGS
Management of Gastrointestinal Stromal Tumors
CLINICAL PRESENTATION
WORKUP
RISK STRATIFICATION
SURGERY FOR PRIMARY DISEASE
ENDOSCOPIC MANAGEMENT OF GIST
NEOADJUVANT THERAPY
ADJUVANT THERAPY
RECURRENT, METASTATIC, AND RESISTANT DISEASE
CONCLUSION
SUGGESTED READINGS
Gastrointestinal Tubes for Feeding and Decompression
INTRODUCTION
NASOGASTRIC TUBE
FEEDING TUBES
SUGGESTED READINGS
Management of Morbid Obesity
PATIENT SELECTION
OPERATIVE PROCEDURES
ENHANCED RECOVERY AFTER SURGERY
OUTCOMES AND COMPLICATIONS
SUGGESTED READINGS
Small Bowel
Management of Small Bowel Obstruction
INTRODUCTION
CAUSES
CLINICAL PRESENTATION
DIAGNOSIS
CLASSIFICATION
MANAGEMENT
SBO WITH CONFOUNDING CONDITIONS
CONCLUSION
SUGGESTED READINGS
Management of Crohn’s Disease of the Small Bowel
MULTIDISCIPLINARY MANAGEMENT
MEDICAL TREATMENT
INDICATIONS FOR SURGERY
PREOPERATIVE CONSIDERATIONS
TECHNICAL CONSIDERATIONS FOR SURGICAL INTERVENTION
POSTOPERATIVE CARE
SUGGESTED READINGS
Use of Strictureplasty in Crohn’s Disease
CLINICAL PRESENTATION
INDICATIONS AND CONTRAINDICATIONS FOR STRICTUREPLASTY
OPERATIVE PLANNING
STRICTUREPLASTY TECHNIQUES
SUMMARY
SUGGESTED READINGS
Management of Small Bowel Tumors
PRESENTATION
MANAGEMENT
SUMMARY
SUGGESTED READINGS
Small Bowel Diverticulosis
INTRODUCTION
DETECTION AND MANAGEMENT OF ASYMPTOMATIC (INCIDENTALLY DISCOVERED) SMALL BOWEL DIVERTICULOSIS
DETECTION AND MANAGEMENT OF SYMPTOMATIC SMALL BOWEL DIVERTICULOSIS
SUGGESTED READINGS
Diagnosis and Management of Motility Disorders of the Stomach and Small Bowel in the Current Era
INTRODUCTION
MOTILITY DISORDERS OF THE STOMACH
GASTROPARESIS-LIKE SYNDROMES
DIABETIC GASTROPARESIS
RAPID GASTRIC EMPTYING
MOTILITY DISORDERS OF THE SMALL INTESTINE
SUGGESTED READINGS
Management of Short Bowel Syndrome
THERAPEUTIC GOALS
SURGICAL STRATEGIES
MULTIDISCIPLINARY APPROACH
SUGGESTED READINGS
Management of Enterocutaneous Fistulas
OVERVIEW
PRESENTATION
CLASSIFICATION
STABILIZATION AND SEPSIS CONTROL
LONG-TERM MANAGEMENT
SPONTANEOUS CLOSURE
OPERATIVE INTERVENTION
SUMMARY
SUGGESTED READINGS
Management of Radiation-Induced Injury to the Small and Large Bowel
INTRODUCTION
PATHOPHYSIOLOGY AND HISTOPATHOLOGY
RISK FACTORS
RADIATION THERAPY TOXICITY GRADING SYSTEMS
CLINICAL FEATURES
DIAGNOSIS
MANAGEMENT STRATEGIES
PREVENTION
SUGGESTED READINGS
Large Bowel
Preoperative Bowel Preparation: Is It Necessary?
TYPES OF BOWEL PREPARATION
MECHANICAL BOWEL PREP VS ORAL ANTIBIOTICS VS NO BOWEL PREPARATION
OUTCOMES OF SURGERY DEPENDENT ON TYPE OF SURGERY
BOWEL PREPARATION IN ERAS
CONCLUSION
SUGGESTED READINGS
Management of Diverticular Disease of the Colon
INTRODUCTION
MANAGEMENT OF DIVERTICULITIS
MANAGEMENT OF DIVERTICULAR BLEEDING
CONCLUSION
SUGGESTED READINGS
Management of Chronic Ulcerative Colitis
INTRODUCTION
EXTRACOLONIC MANIFESTATIONS OF UC
RISK FACTORS
DIAGNOSIS
MEDICAL THERAPY
SURGERY AND ULCERATIVE COLITIS
PERIOPERATIVE AND POSTOPERATIVE CONSIDERATIONS
SUMMARY
SUGGESTED READINGS
Management of Toxic Megacolon
CAUSE, INCIDENCE, AND PATHOGENESIS
DIAGNOSIS
THERAPY
OUTCOMES
SUMMARY
SUGGESTED READINGS
Surgical Management of Crohn’s Colitis
INTRODUCTION
MEDICAL MANAGEMENT
INDICATION FOR SURGICAL INTERVENTION
PREOPERATIVE OPTIMIZATION
SURGICAL MANAGEMENT
SURGICAL PEARLS
POSTOPERATIVE MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Ischemic Colitis
DEFINITION AND EPIDEMIOLOGY
ETIOLOGY
CLASSIFICATION
PRESENTATION
DIAGNOSIS
SEVERITY
SURGICAL APPROACH
POSTOPERATIVE COURSE
CONCLUSION
SUGGESTED READINGS
Management of Clostridioides Difficile Colitis
BACKGROUND
CLINICAL PRESENTATION
DIAGNOSIS
MEDICAL TREATMENT
SURGICAL MANAGEMENT
SPECIAL POPULATION: PATIENTS WITH INFLAMMATORY BOWEL DISEASE
CONCLUSION
SUGGESTED READINGS
Management of Large Bowel Obstruction
ETIOLOGY
CLINICAL PRESENTATION
DIAGNOSIS
TREATMENT
SPECIFIC SITUATIONS
SUMMARY
SUGGESTED READINGS
Enteral Stents in the Treatment of Colonic Obstruction
INTRODUCTION
INITIAL EVALUATION
INDICATIONS FOR STENT PLACEMENT
CONTRAINDICATIONS TO COLONIC STENTS
FOLLOW-UP CARE
OUTCOMES AND ADVERSE EVENTS
CONCLUSION
SUGGESTED READINGS
Management of Acute Colonic Pseudo-Obstruction (Ogilvie’s Syndrome)
CLINICAL MANIFESTATIONS AND DIAGNOSIS
MANAGEMENT
COLONOSCOPIC DECOMPRESSION
PERCUTANEOUS CECOSTOMY
SURGICAL THERAPY
SUMMARY
SUGGESTED READINGS
Management of Colonic Volvulus
INTRODUCTION
SIGMOID VOLVULUS
CECAL VOLVULUS
SUMMARY
SUGGESTED READINGS
Management of Rectal Prolapse
ETIOLOGY
PRESENTATION
EVALUATION
MANAGEMENT/SURGICAL APPROACH
PARTIAL THICKNESS PROLAPSE
FULL THICKNESS PROLAPSE
CONCLUSION
SUGGESTED READINGS
Surgical Management of Constipation
ANATOMY AND PHYSIOLOGY
DIAGNOSIS
MANAGEMENT
ADULT HIRSCHSPRUNG’S DISEASE
CONCLUSION
SUGGESTED READINGS
Surgical Management of the Polyposis Syndromes
INTRODUCTION
ADENOMATOUS POLYPOSIS SYNDROMES
CHEMOPREVENTION
SURGERY
OTHER POLYPOSIS SYNDROMES
SUGGESTED READINGS
Surgical Management of Colon Cancer
CLINICAL PRESENTATION AND SCREENING
PREOPERATIVE EVALUATION AND STAGING
SURGICAL MANAGEMENT
SPECIAL SCENARIOS
TUMOR-RELATED EMERGENCIES
ADJUVANT THERAPY
SURVEILLANCE
CONCLUSION
SUGGESTED READINGS
PET Scanning in the Management of Colorectal Cancer
INTRODUCTION
POSITRON EMISSION TOMOGRAPHY CONCEPTS AND DEFINITIONS
INITIAL DIAGNOSIS, WORKUP, AND STAGING OF COLORECTAL CANCER
THE ROLE OF PREOPERATIVE FDG-PET CT IN COLORECTAL MALIGNANCY
POSTTREATMENT EVALUATION OF COLORECTAL MALIGNANCY
COLORECTAL CANCER SURVEILLANCE
THE ROLE OF PET CT IN COLORECTAL LIVER METASTASES
FDG-PET MRI
CONCLUSION
SUGGESTED READINGS
Neoadjuvant and Adjuvant Therapy for Colorectal Cancer
STAGING
RECTAL CANCER
SURVEILLANCE
SUGGESTED READINGS
Management of Colorectal Polyps
OVERVIEW
HISTOPATHOLOGY OF POLYPS
TECHNIQUES FOR EXCISING POLYPS
APPROACH TO THE MALIGNANT POLYP
Suggested Reading
Management of Peritoneal Surface Malignancies
EPIDEMIOLOGY AND CLASSIFICATION
CLINICAL MANIFESTATION
PREOPERATIVE WORKUP
PATIENT SELECTION
COLORECTAL CANCERS
GASTRIC CANCER
PERITONEAL MESOTHELIOMA
OVARIAN CANCER
SUGGESTED READINGS
Management of Lower Gastrointestinal Bleeding
INTRODUCTION
MANAGEMENT
SURGICAL CONSIDERATIONS
CONCLUSION
SUGGESTED READINGS
Appendicitis: Diagnosis and Management
ANATOMY OF THE APPENDIX
PATHOLOGY OF ACUTE APPENDICITIS
CLINICAL PRESENTATION AND DIAGNOSTIC WORKUP
MANAGEMENT OF ACUTE APPENDICITIS
CURRENT CONTROVERIES
SUMMARY
SUGGESTED READINGS
Anorectal
Management of Hemorrhoids
INTRODUCTION
ETIOLOGY AND SYMPTOMS
TREATMENT
SPECIAL SITUATIONS AND COMPOUNDING CONDITIONS
SUMMARY
SUGGESTED READINGS
Management of Fissure-In-Ano
INTRODUCTION
NONOPERATIVE MANAGEMENT
OPERATIVE MANAGEMENT
SPECIAL CONSIDERATIONS
SUGGESTED READINGS
Management of Anorectal Abscess and Fistula
ANORECTAL ABSCESS
FISTULA-IN-ANO
SUGGESTED READINGS
Anal Stenosis
BACKGROUND
DIAGNOSIS
MANAGEMENT
POSTOPERATIVE CARE AND COMPLICATIONS
SELECTION OF SURGICAL TECHNIQUE
SUGGESTED READINGS
Management of Pruritus Ani
DEFINITION
ETIOLOGY
EVALUATION AND DIAGNOSIS
MANAGEMENT
SUGGESTED READINGS
Surgical Management of Fecal Incontinence
INTRODUCTION
DIAGNOSTIC EVALUATION
NONOPERATIVE MANAGEMENT
SURGICAL MANAGEMENT
CONCLUSIONS
SUGGESTED READINGS
Rectovaginal Fistula
ETIOLOGY AND CLASSIFICATION
EVALUATION
ABDOMINAL APPROACHES
PERINEAL APPROACHES
TRANSVAGINAL REPAIRS
SUGGESTED READINGS
Anal Condyloma
OVERVIEW
INCIDENCE
RISK FACTORS
PATHOGENESIS, PRESENTATION, AND DETECTION
MANAGEMENT OF ANAL CONDYLOMA
GIANT CONDYLOMA ACUMINATA
ANAL SQUAMOUS INTRAEPITHELIAL LESION
HUMAN PAPILLOMAVIRUS VACCINE
SUGGESTED READINGS
Management of Pilonidal Disease
INTRODUCTION
TREATMENT
SUGGESTED READINGS
Pneumatosis Intestinalis and the Importance for the Surgeon
INTRODUCTION
BENIGN CAUSES OF PNEUMATOSIS INTESTINALIS
PNEUMATOSIS INTESTINALIS RESULTING FROM AN INTRAABDOMINAL EMERGENCY
IMAGING FINDINGS
SURGICAL MANAGEMENT OF PATHOLOGIC PNEUMATOSIS INTESTINALIS
SUGGESTED READINGS
Management of Rectal Cancer
BACKGROUND
CLINICAL EVALUATION AND CLINICAL STAGING
NEOADJUVANT THERAPY
MANAGEMENT OF TUMOR-RELATED COMPLICATIONS
RADICAL RESECTION
LOCAL EXCISION
NONOPERATIVE MANAGEMENT
MANAGEMENT OF METASTATIC DISEASE
POSTOPERATIVE MANAGEMENT/SURVEILLANCE
SUGGESTED READINGS
Management of Tumors of the Anal Region
OVERVIEW AND ANATOMY
SQUAMOUS NEOPLASMS
COLUMNAR NEOPLASMS
MELANOMA
NEUROENDOCRINE AND MESENCHYMAL TUMORS
MALIGNANT LYMPHOMA
SUGGESTED READINGS
Liver
Cystic Disease of The Liver
INTRODUCTION
CONCLUSION
SUGGESTED READINGS
Management of Echinococcal Cyst Disease of the Liver
PATHOLOGY AND CLASSIFICATION
PRESENTATION AND DIAGNOSIS
TREATMENT
SUMMARY
RESULTS
SUGGESTED READINGS
Management of Liver Hemangioma
OVERVIEW
RUPTURED HEMANGIOMATA, KASABACH-MERRITT SYNDROME, AND BUDD-CHIARI SYNDROME
MASQUERADING LESIONS
SUGGESTED READINGS
Management of Benign Liver Tumors
RADIOGRAPHIC EVALUATION OF LIVER LESIONS
BENIGN LIVER CYSTS
MUCINOUS CYSTIC NEOPLASM
HEPATIC HEMANGIOMA
HEPATIC ADENOMA
FOCAL NODULAR HYPERPLASIA
SUMMARY
SUGGESTED READINGS
Management of Malignant Liver Tumors
PRIMARY LIVER TUMORS
METASTATIC LIVER TUMORS
PREOPERATIVE EVALUATION
TECHNICAL CONSIDERATIONS
HEPATECTOMY
SUGGESTED READINGS
Hepatic Malignancy: Resection Versus Transplantation
INTRODUCTION
PATIENT EVALUATION
ASSESSMENT OF LIVER FUNCTION
RESECTION FOR HEPATOCELLULAR CARCINOMA
LIVER TRANSPLANTATION IN HEPATOCELLULAR CARCINOMA
FUTURE DIRECTIONS
SUMMARY
SUGGESTED READINGS
Management of Colorectal Liver Metastases
INTRODUCTION
EVALUATION
ROLE OF CHEMOTHERAPY
SURGICAL RESECTION
LOCOREGIONAL THERAPIES
SPECIFIC CLINICAL SCENARIOS
CONCLUSION
SUGGESTED READINGS
Ablation of Colorectal Carcinoma Liver Metastases
INTRODUCTION
ABLATION MODALITIES
PATIENT SELECTION
PATIENT EVALUATION
CHOOSING A TREATMENT MODALITY
SUMMARY
SUGGESTED READINGS
Management of Hepatic Abscess
PYOGENIC LIVER ABSCESS
AMEBIC LIVER ABSCESS
FUNGAL HEPATIC ABSCESS
SUGGESTED READINGS
Transarterial Therapies for Primary and Metastatic Liver Tumors
INTRODUCTION
TRANSARTERIAL THERAPIES
POSTPROCEDURE FOLLOW-UP
TOXICITIES AND COMPLICATIONS
OUTCOMES
CANCER-SPECIFIC OUTCOMES
NEW DEVELOPMENTS AND FUTURE DIRECTIONS
SUMMARY
SUGGESTED READINGS
Portal Hypertension
Portal Hypertension: Role of Shunting Procedures
INTRODUCTION
COMPLICATIONS OF PORTAL HYPERTENSION
TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT
SURGICAL SHUNTS
CONCLUSION
SUGGESTED READINGS
Liver Transplantation
HISTORY
IMMUNOSUPPRESSION
LIVER TRANSPLANTATION
OUTCOMES
VASCULAR COMPLICATIONS
LIVING DONOR LIVER TRANSPLANTATION
SUGGESTED READINGS
Endoscopic Therapy for Esophageal Variceal Hemorrhage
PORTAL HYPERTENSION AND VARICES
ENDOSCOPIC SCREENING FOR ESOPHAGEAL VARICES
PRIMARY PREVENTION
MANAGEMENT OF ACUTE GASTROESOPHAGEAL VARICEAL HEMORRHAGE
MANAGEMENT OF ENDOSCOPIC TREATMENT FAILURES
SUMMARY
SUGGESTED READINGS
Transjugular Intrahepatic Portosystemic Shunt
INTRODUCTION
INDICATIONS
TECHNIQUE
SPECIAL CASES
CLINICAL OUTCOMES
SUMMARY
SUGGESTED READINGS
Management of Refractory Ascites
INTRODUCTION
SPONTANEOUS BACTERIAL PERITONITIS
MEDICAL TREATMENT CONSIDERATIONS IN REFRACTORY ASCITES
INTERVENTIONAL METHODS IN THE TREATMENT OF REFRACTORY ASCITES
EXPERIMENTAL OPTIONS
SUGGESTED READINGS
Management of Hepatic Encephalopathy
PATHOPHYSIOLOGY
DIAGNOSIS AND GRADING
PRECIPITATING FACTORS
TREATMENT FOR HE IN CHRONIC LIVER DISEASE
OTHER THERAPIES REQUIRING FURTHER RESEARCH
OTHER CONSIDERATIONS
SUGGESTED READINGS
Management of Budd-Chiari Syndrome
INTRODUCTION
PATHOGENESIS
PRESENTATION
DIAGNOSIS
MEDICAL MANAGEMENT
SURGICAL MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Gallbladder and Biliary Tree
Management of Asymptomatic (Silent) Gallstones
NATURAL HISTORY OF CHOLELITHIASIS
RISK OF PROGRESSION TO SYMPTOMATIC CHOLELITHIASIS
MORBIDITY ASSOCIATED WITH LAPAROSCOPIC CHOLECYSTECTOMY VERSUS EXPECTANT MANAGEMENT
SPECIFIC PATIENT POPULATIONS
SUMMARY
SUGGESTED READINGS
Management of Biliary Dyskinesia
EPIDEMIOLOGY
CLINICAL PRESENTATION, EVALUATION, AND DIAGNOSIS
SUGGESTED READINGS
Management of Acute Cholecystitis
INTRODUCTION
CLINICAL PRESENTATION, EVALUATION, AND DIAGNOSIS
SURGICAL MANAGEMENT
MEDICAL MANAGEMENT
PERCUTANEOUS DRAINAGE
ENDOSCOPIC THERAPY
SPECIAL CONSIDERATIONS
SUGGESTED READINGS
Proper Use of Cholecystotomy Tubes
INTRODUCTION
INDICATIONS FOR CHOLECYSTOSTOMY TUBE PLACEMENT
GALLBLADDER PATHOLOGY FACTORS
PATIENT-RELATED FACTORS
ROLE OF CHOLECYSTOSTOMY TUBE PLACEMENT IN COVID-19 PATIENTS
APPROACHES TO CHOLECYSTOSTOMY TUBE PLACEMENT
COMPLICATIONS OF CHOLECYSTOSTOMY TUBE PLACEMENT
LONG-TERM MANAGEMENT OF CHOLECYSTOSTOMY TUBES
DEFINITIVE TREATMENT WITH CHOLECYSTECTOMY
PROPOSED ALGORITHM FOR CHOLECYSTOSTOMY TUBE PLACEMENT AND MANAGEMENT
SUGGESTED READINGS
Management of Common Bile Duct Stones
EPIDEMIOLOGY
PATHOPHYSIOLOGY AND PRESENTATION
DIAGNOSIS
MANAGEMENT
SUGGESTED READINGS
Management of Acute Cholangitis
INTRODUCTION
EPIDEMIOLOGY
PATHOPHYSIOLOGY
DIAGNOSTIC WORKUP
MANAGEMENT
AREAS OF RECENT INVESTIGATION
CONCLUSION
SUGGESTED READINGS
Management of Benign Biliary Strictures
IATROGENIC BILE DUCT INJURY AND STRICTURE
NONIATROGENIC BILIARY STRICTURES
SUGGESTED READINGS
Management of Cystic Disorders of the Bile Ducts
EPIDEMIOLOGY
ETIOLOGY
CLASSIFICATION
CLINICAL PRESENTATION
DIAGNOSIS
WHEN IS A DILATED COMMON BILE DUCT A CHOLEDOCHAL CYST?
MANAGEMENT
PROGNOSIS
SUGGESTED READINGS
Management of Primary Sclerosing Cholangitis
CLINICAL PRESENTATION
NATURAL HISTORY
ASSOCIATED DISEASES AND COMPLICATIONS
DIAGNOSIS
THERAPY
SUMMARY
SUGGESTED READINGS
Management of Intrahepatic, Perihilar, and Distal Extrahepatic Cholangiocarcinoma
INTRODUCTION
INTRAHEPATIC CHOLANGIOCARCINOMA
HILAR CHOLANGIOCARCINOMA
DISTAL CHOLANGIOCARCINOMA
SUMMARY
SUGGESTED READINGS
Biomarker Guided Surgical Management of Hepatobiliary and Pancreatic Tumors
INTRODUCTION
LIQUID COMPONENT OF A SOLID TUMOR: DEFINING ANATOMIC AND BIOLOGIC RESECTABILITY
INTEGRATING ANATOMIC AND BIOLOGIC RESECTABILITY IN HEPATOBILIARY AND PANCREATIC SURGERY
DEFINING A BIOMARKER
TUMOR BIOMARKER PORTRAIT IN HEPATOBILIARY AND PANCREATIC SURGERY
CURRENT BIOMARKERS TO GUIDE SURGICAL MANAGEMENT OF HEPATOBILIARY AND PANCREATIC TUMORS
THE FUTURE OF BIOMARKERS: PRECISION HEPATOBILIARY AND PANCREATIC SURGERY
SUGGESTED READINGS
Surgical Management of Gallbladder Cancer
OVERVIEW
EPIDEMIOLOGY
RISK FACTORS
STAGING
BRIEF ANATOMY AND PHYSIOLOGY OF THE GALLBLADDER
PRESENTATION, WORKUP, AND MANAGEMENT
SURVIVAL
ADJUVANT THERAPY
SUMMARY
SUGGESTED READINGS
Management of Gallstone Ileus
PATHOGENESIS
PRESENTATION
DIAGNOSIS
PREOPERATIVE MANAGEMENT
SURGICAL MANAGEMENT
SUGGESTED READINGS
Transhepatic Interventions for Obstructive Jaundice
INTRODUCTION
PERCUTANEOUS CHOLANGIOGRAM TECHNIQUE SUMMARY
COMPLICATIONS OF TRANSHEPATIC PERCUTANEOUS BILIARY INTERVENTIONS
MANAGEMENT OF BENIGN CAUSES OF BILIARY OBSTRUCTION
SUMMARY
SUGGESTED READINGS
Obstructive Jaundice: The Role of Endoscopic Intervention
CLINICAL PRESENTATION
EVALUATION OF OBSTRUCTIVE JAUNDICE
OVERVIEW OF ENDOSCOPIC APPROACHES TO THERAPY AND MAJOR ADVERSE EFFECTS
APPROACHES IN COMMON CAUSES OF OBSTRUCTIVE JAUNDICE
SUGGESTED READINGS
Pancreas
Management of Acute Necrotizing Pancreatitis
DIAGNOSIS AND EVALUATION
INITIAL MANAGEMENT
INTERVENTIONAL MANAGEMENT
KEY PANCREATITIS-RELATED COMPLICATIONS
RECURRENCE PREVENTION
SUGGESTED READINGS
Gallstone Pancreatitis
EPIDEMIOLOGY
PATHOPHYSIOLOGY
CLINICAL PRESENTATION
DIAGNOSIS
SEVERITY
MANAGEMENT: INITIAL TREATMENT
MANAGEMENT: TIMING OF CHOLECYSTECTOMY
MANAGEMENT: IDIOPATHIC ACUTE PANCREATITIS
SYSTEMIC COMPLICATIONS OF GALLSTONE PANCREATITIS
SUMMARY
SUGGESTED READINGS
Pancreas Divisum and Other Variants of Dominant Dorsal Duct Anatomy
DIAGNOSIS
ENDOSCOPIC TREATMENT
SURGICAL TREATMENT
LATERAL PANCREATICOJEJUNOSTOMY
WHIPPLE PROCEDURE
HYBRID PROCEDURES
TOTAL PANCREATECTOMY WITH ISLET AUTOTRANSPLANTATION
CONCLUSION
SUGGESTED READINGS
Diagnosis and Management of Autoimmune Pancreatitis
INTRODUCTION
DIAGNOSIS AND EVALUATION
INTERNATIONAL CONSENSUS DIAGNOSTIC CRITERIA
FINDINGS NOT TYPICAL OF AIP
TREATMENT
FOLLOW-UP AND SURVEILLANCE
SUMMARY
SUGGESTED READINGS
Management of Pancreatic Necrosis
DEFINITIONS AND DIAGNOSIS
INITIAL MANAGEMENT
INDICATIONS AND TIMING OF INTERVENTIONS
THE STEP-UP APPROACH
CONCLUSION
SUGGESTED READINGS
Management of Pancreatic Pseudocyst
INTRODUCTION
DEFINITION AND CLASSIFICATION
PATHOPHYSIOLOGY
PRESENTATION AND EVALUATION
MANAGEMENT
POSTOPERATIVE CONCERNS
CONCLUSION
SUGGESTED READINGS
Pancreatic Ductal Disruptions Leading to Pancreatic Fistula, Pancreatic Ascites, or Pancreatic Pleural Effusion
DEFINITIONS
CLINICAL PRESENTATION AND DIAGNOSIS
INDICATIONS AND RATIONALE FOR TREATMENT
SUMMARY
SUGGESTED READINGS
Management of Chronic Pancreatitis
DEFINITION
ETIOLOGY
DIAGNOSIS
MANAGEMENT
SUGGESTED READINGS
Genetic Testing and High-Risk Pancreatic Cancer Screening
CASE PRESENTATION
CLINICAL QUESTIONS TO BE ADDRESSED
BACKGROUND
HIGH-RISK INDIVIDUALS
EFFECTIVENESS OF SCREENING
SCREENING GUIDELINES
MANAGEMENT OF CYSTIC LESIONS IN HIGH-RISK INDIVIDUALS
PARADIGM SHIFT OF CRITICAL ASSESSMENT
CASE PRESENTATION REVISITED
CONCLUSION
SUGGESTED READINGS
Management of Periampullary Cancers
INTRODUCTION
CLINICAL PRESENTATION AND DIAGNOSTIC WORKUP
MULTIDISCIPLINARY MANAGEMENT
SURGICAL MANAGEMENT
POSTOPERATIVE CARE
SUMMARY
SUGGESTED READINGS
Management of Complications after the Whipple Procedure
CLINICALLY RELEVANT POSTOPERATIVE PANCREATIC FISTULA
POST-PANCREATECTOMY ACUTE PANCREATITIS (PPAP)
POSTPANCREATECTOMY HEMORRHAGE
DELAYED GASTRIC EMPTYING
CHYLE LEAK
SUGGESTED READINGS
Vascular Reconstruction During the Whipple Operation
PATIENT SELECTION FOR ELECTIVE VASCULAR PANCREATIC SURGERY
VENOUS RECONSTRUCTION
ARTERIAL RECONSTRUCTION
PERIADVENTITIAL DISSECTION OF ARTERIES
ROBOTIC VASCULAR PANCREATIC SURGERY
POSTOPERATIVE MANAGEMENT AND COMPLICATIONS
SUMMARY
SUGGESTED READINGS
Palliative Interventions for Patients with Operable and Advanced Pancreatic and Periampullary Cancer
INITIAL EVALUATION OF THE PATIENT WITH PANCREATIC/PERIAMPULLARY CANCER
BILE DUCT OBSTRUCTION
GASTRIC OUTLET (DUODENAL) OBSTRUCTION
OPEN PROPHYLACTIC BILIARY AND GASTRIC BYPASS
PALLIATIVE PANCREATICODUODENECTOMY
MALIGNANT BOWEL OBSTRUCTION
MALIGNANT ASCITES
VASCULAR THROMBOSIS
TUMOR-ASSOCIATED PAIN MANAGEMENT
DEPRESSION
CONCLUSION
SUGGESTED READINGS
Neoadjuvant and Adjuvant Therapy for Pancreatic Cancer
DEFINING THE CLINICAL STAGE OF DISEASE
RESECTABLE PANCREATIC CANCER
BORDERLINE RESECTABLE PANCREATIC CANCER
LOCALLY ADVANCED PANCREATIC CANCER
CONCLUSION AND FUTURE DIRECTIONS
SUGGESTED READINGS
Rare and Unusual Pancreatic Tumors
INTRODUCTION
BENIGN PANCREATIC CYSTS
NEOPLASTIC PANCREATIC CYSTS
EPITHELIAL CELL TUMORS
MESENCHYMAL PANCREATIC TUMORS
PEComa
INFLAMMATORY MASSES AND SECONDARY MALIGNANCIES
ADDITIONAL MALIGNANCIES
CONCLUSION
SUGGESTED READINGS
Intraductal Papillary Mucinous Neoplasms of the Pancreas
CLINICAL CLASSIFICATION OF MALIGNANT POTENTIAL
CLINICAL EVALUATION FOR EXTRAPANCREATIC MALIGNANCIES
CONCLUSION
SUGGESTED READINGS
Pancreatic Neuroendocrine Tumors of the Pancreas Excluding Gastrinoma
INTRODUCTION
CLASSIFICATION
PRESENTATION
DIAGNOSTIC EVALUATION
MANAGEMENT OF PNETs
SURGICAL APPROACHES
MANAGEMENT OF UNRESECTABLE PNETs
CONCLUSION
SUGGESTED READINGS
Intraoperative Radiation for Pancreatic Cancer
INTRODUCTION
REVIEW OF EXISTING LITERATURE
PATIENT SELECTION
EQUIPMENT
TECHNIQUE
TARGET VOLUME DELINEATION
DOSING
NORMAL TISSUE TOXICITY
CONCLUSION
SUGGESTED READINGS
Transplantation of the Pancreas
INTRODUCTION
WHOLE-ORGAN PANCREAS TRANSPLANTATION
COMPLICATIONS
RESULTS
RISK-TO-BENEFIT CONSIDERATIONS
FUTURE DIRECTIONS
SUGGESTED READINGS
Total Pancreatectomy and Islet Autotransplantation for Chronic Pancreatitis
INTRODUCTION
PATIENT SELECTION
EVIDENCE
PREOPERATIVE EVALUATION
SURGICAL PLANNING
COUNSELING AND DECISION MAKING
OPERATIVE TECHNIQUE
INTRAOPERATIVE CARE
POSTOPERATIVE CARE
OTHER CONSIDERATIONS
SUGGESTED READINGS
Spleen
Splenectomy for Hematologic Disorders
INTRODUCTION
BENIGN CONDITIONS
PLATELET DISORDERS
MALIGNANT CONDITIONS
MYELOPROLIFERATIVE DISORDERS
PRIMARY TUMORS OF THE SPLEEN AND METASTASIS
MISCELLANEOUS CONDITIONS
PERIOPERATIVE CONSIDERATIONS
SPLENECTOMY TECHNIQUES
CONCLUSIONS
SUGGESTED READINGS
Management of Cysts, Tumors, and Abscesses of the Spleen
SURGICAL ANATOMY OF THE SPLEEN
SPLENIC CYSTS
SPLENIC PELIOSIS
SPLENIC TUMORS
SPLENIC ABSCESS
SURGERY
SUGGESTED READINGS
Hernia
Management of Inguinal Hernia
INDICATIONS AND TIMING OF REPAIR
CONSIDERATIONS IN SELECTING THE OPERATIVE APPROACH
OPEN INGUINAL HERNIA REPAIR
MINIMALLY INVASIVE INGUINAL HERNIA REPAIR
TAPP VERSUS TEP?
CHRONIC PAIN AFTER INGUINAL HERNIA REPAIR
CONCLUSION
SUGGESTED READINGS
Management of Recurrent Inguinal Hernia
INTRODUCTION
RISK FACTORS FOR RECURRENCE
PREOPERATIVE EVALUATION
TECHNIQUES FOR REPAIR OF RECURRENCE
CONCLUSION
SUGGESTED READINGS
Incisional, Epigastric, and Umbilical Hernias
PATIENT SELECTION
SURGICAL CONSIDERATIONS
OPEN SURGICAL REPAIR OF INCISIONAL HERNIAS
LAPAROSCOPIC/ROBOTIC APPROACH
EPIGASTRIC AND UMBILICAL HERNIAS
PERIOPERATIVE AND POSTOPERATIVE CARE
COMMON COMPLICATIONS
CONCLUSION
Acknowledgment
SUGGESTED READINGS
Management of Spigelian, Obturator, and Lumbar Hernias
SPIGELIAN HERNIA
OBTURATOR HERNIA
LUMBAR HERNIA
SUGGESTED READINGS
Athletic Pubalgia
APPROACH TO GROIN PAIN
GROIN PAIN CONSIDERATIONS
WORKUP/IMAGING
MANAGEMENT
SURGERY AND CLINICAL ENTITIES
OTHER SOURCES of GROIN PAIN
OUTCOME MEASURES
SUMMARY
SUGGESTED READINGS
Abdominal Wall Reconstruction
INTRODUCTION
ANATOMY
PATIENT SELECTION AND PREPARATION FOR AWR
SURGICAL TECHNIQUES
POSTOPERATIVE CARE AND OUTCOMES
PROCEDURE SELECTION STRATEGIES
SUGGESTED READINGS
Loss of Domain in Abdominal Wall Reconstruction
DEFINITION
ETIOLOGY
OPERATIVE PLANNING
STRATEGIES TO MIND THE GAP
SUMMARY
SUGGESTED READINGS
Use of Various Meshes in Hernia Repair
INTRODUCTION
MESH PROPERTIES
MESH CLASSES
MESH LOCATION
SUBLAY
ONLAY
INLAY
IMPORTANT TENETS OF SKIN AND SOFT TISSUE MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Breast
Benign Breast Disease
GENERAL CONSIDERATIONS
COMMON BREAST COMPLAINTS
MANAGEMENT OF BENIGN BREAST MASSES AND LESIONS
SPECIAL POPULATIONS
SUGGESTED READINGS
Screening for Breast Cancer
INTRODUCTION
SCREENING MODALITIES
SCREENING RECOMMENDATIONS
SUMMARY
SUGGESTED READINGS
Role of Stereotactic Biopsy in Management of Breast Disease
TECHNIQUES
INDICATIONS
CONTRAINDICATIONS
EQUIPMENT
PROCEDURE
COMPLICATIONS
CONCORDANCE
FOLLOW-UP
SUGGESTED READINGS
Molecular Targets in Breast Cancer
INTRODUCTION
BREAST CANCER SUBTYPES
HORMONE RECEPTOR–POSITIVE BREAST CANCER
HER2-POSITIVE BREAST CANCER
TRIPLE-NEGATIVE BREAST CANCER
HER2-LOW BREAST CANCER
CONCLUSION
SUGGESTED READINGS
Breast Cancer: Surgical Therapy
SCREENING FOR BREAST CANCER
DIAGNOSIS OF BREAST CANCER
DISCUSSION OF SURGICAL OPTIONS
LUMPECTOMY
MASTECTOMY
MANAGEMENT OF THE AXILLA
INFLAMMATORY BREAST CANCER
LOCALLY ADVANCED BREAST CANCER
BREAST CANCER STAGING: AMERICAN JOINT COMMITTEE ON CANCER
ADJUVANT THERAPY
SURGERY FOR STAGE IV BREAST CANCER
CONCLUSION
SUGGESTED READINGS
Pregnancy and Breast Cancer Management
EPIDEMIOLOGY OF BREAST CANCER IN PREGNANCY
PREGNANCY CHANGES TO THE BREAST
PRESENTATION AND DIAGNOSTIC WORKUP
HISTOLOGY OF BREAST CANCER IN PREGNANCY
TREATMENT: BREAST CANCER IN PREGNANCY
SURGICAL CONSIDERATIONS
CHEMOTHERAPY IN PREGNANCY
PEDIATRIC OUTCOMES AFTER MATERNAL CANCER DIAGNOSIS
KEY POINTS
SUGGESTED READINGS
Ablative Techniques in the Treatment of Benign and Malignant Breast Disease
RADIOFREQUENCY ABLATION
MICROWAVE ABLATION
CRYOABLATION
HIGH-INTENSITY FOCUSED ULTRASOUND
INTERSTITIAL LASER
IRREVERSIBLE ELECTROPORATION
SUMMARY
SUGGESTED READINGS
Lymphatic Mapping and Sentinel Lymphadenectomy
INTRODUCTION
INDICATIONS FOR SENTINEL LYMPH NODE BIOPSY
SLNB: TECHNIQUE
TROUBLESHOOTING SLNB
RESULTS OF SLNB AND LYMPHATIC MAPPING
CONCLUSION
SUGGESTED READINGS
Surgical Management of the Axilla
OVERVIEW
SURGICAL APPROACHES TO AXILLARY LYMPH NODE DISSECTION
SENTINEL LYMPH NODE BIOPSY: HISTORY
AVOIDING AXILLARY LYMPH NODE DISSECTION IN PATIENTS WITH SENTINEL NODE METASTASES
MANAGEMENT OF THE AXILLA IN PATIENTS RECEIVING NEOADJUVANT CHEMOTHERAPY
THE NEXT FRONTIER IN DEESCALATION OF AXILLARY MANAGEMENT: ONGOING TRIALS OF AXILLARY MANAGEMENT AFTER NEOADJUVANT THERAPY
SUMMARY
SUGGESTED READINGS
Inflammatory Breast Cancer
INTRODUCTION
WORKUP
TREATMENT FOR NONMETASTATIC IBC
SURGICAL APPROACH TO IBC
MODIFIED RADICAL MASTECTOMY
POSTOPERATIVE MANAGEMENT
SPECIAL CONSIDERATIONS FOR SURGERY
POTENTIAL SURGICAL COMPLICATIONS AND MANAGEMENT STRATEGIES
OTHER CONSIDERATIONS
SUGGESTED READINGS
Ductal and Lobular Carcinoma in situ of the Breast
DUCTAL CARCINOMA IN SITU
LOBULAR CARCINOMA IN SITU
SUGGESTED READINGS
Advances in Neoadjuvant and Adjuvant Therapy for Early-Stage Breast Cancer
ROLE OF RECEPTOR STATUS IN DETERMINING TIMING OF CHEMOTHERAPY (NEOADJUVANT VS. ADJUVANT)
HR+/HER2- BREAST CANCER
TRIPLE NEGATIVE BREAST CANCER
HER2+ BREAST CANCER SUBTYPE
IMMUNOTHERAPY IN BREAST CANCER
SUMMARY
SUGGESTED READINGS
Treatment Trends in Locally Recurrent and Metastatic Breast Cancer
BACKGROUND AND EPIDEMIOLOGY
DEFINING A BREAST CANCER RECURRENCE
GENOMIC ASSAYS USED TO STRATIFY RECURRENCE RISK
EVALUATION AND MANAGEMENT OF RECURRENT DISEASE IN BREAST CANCER
AXILLARY LYMPH NODE DISSECTION IN RECURRENT DISEASE
ROLE OF LOCOREGIONAL THERAPY IN METASTATIC DISEASE
FUTURE QUESTIONS TO ANSWER
RECONSTRUCTION IN ADVANCED AND RECURRENT DISEASE
SUGGESTED READINGS
Management of Male Breast Cancer
INTRODUCTION
DIAGNOSIS
TREATMENT
SUGGESTED READINGS
A Surgeon's Practical Guide to Breast Imaging
THE ABNORMAL SCREENING MAMMOGRAM
PALPABLE MASS
NIPPLE DISCHARGE
THE AUGMENTED BREAST
LOCALIZATION
SUGGESTED READINGS
Genetic Counseling and Testing
IMPLICATIONS OF GENETIC TESTING
GENETIC COUNSELING
WHO SHOULD GET TESTED?
WHO ARE WE MISSING?
WHICH GENES ARE TESTED FOR?
WHAT TO DO WITH A POSITIVE RESULT
WHO IS OFFERED RISK-REDUCING MASTECTOMY?
WHAT ARE THE SURGICAL OPTIONS?
SUGGESTED READINGS
Contralateral Prophylactic Mastectomy
INDICATIONS FOR CONTRALATERAL PROPHYLACTIC MASTECTOMY
OUTCOMES OF CONTRALATERAL PROPHYLACTIC MASTECTOMY
SURGICAL RISKS ASSOCIATED WITH CONTRALATERAL PROPHYLACTIC MASTECTOMY
IMPACT ON QUALITY OF LIFE AND PATIENT SATISFACTION
ALTERNATIVES TO CPM
COST-EFFECTIVENESS OF CONTRALATERAL MASTECTOMY
SURGICAL OPTIONS FOR CONTRALATERAL PROPHYLACTIC MASTECTOMY
SHARED DECISION MAKING AND PATIENT EDUCATION
CONTRAINDICATIONS TO CONTRALATERAL PROPHYLACTIC MASTECTOMY
CONCLUSION
SUGGESTED READINGS
Margins: How to and How Big?
PREOPERATIVE PLANNING
OPERATIVE TECHNIQUE
SPECIMEN HANDLING AND PROCESSING
REEXCISION OF MARGINS BASED ON FINAL PATHOLOGY
CONCLUSION
SUGGESTED READINGS
Breast Reconstruction Following Mastectomy: Considerations, Techniques, and Outcomes, Part I
PREOPERATIVE CONSIDERATIONS
AESTHETIC CONSIDERATIONS
RADIATION THERAPY
TIMING OF RECONSTRUCTION
RECONSTRUCTIVE TECHNIQUES (FIG. 1)
COMPLICATIONS
AUTOLOGOUS RECONSTRUCTION
REVISION SURGERIES
BREAST CANCER SURVEILLANCE AFTER BREAST RECONSTRUCTION
SUGGESTED READINGS
Breast Reconstruction Following Mastectomy: Considerations, Techniques, and Outcomes, Part 2
INTRODUCTION
RECONSTRUCTIVE METHODS
TIMING OF RECONSTRUCTION
RISK MANAGEMENT CONSIDERATIONS
SUMMARY
SUGGESTED READINGS
Breast Implant-Associated Anaplastic Large Cell Lymphoma
INTRODUCTION
SCOPE
EPIDEMIOLOGY
PRESENTATION
DIAGNOSIS AND WORKUP
TREATMENT
STAGING
FDA WARNINGS ON IMPLANTS
DECISION MAKING REGARDING PROPHYLACTIC MANAGEMENT
SOFT TISSUE MANAGEMENT FOR PROPHYLAXIS
SUBSEQUENT RECONSTRUCTION
CONCLUSION
SUGGESTED READINGS
Endocrine Glands
Adrenal Incidentaloma
INITIAL EVALUATION
SUGGESTED READINGS
Management of Adrenal Cortical Tumors
INTRODUCTION
PREOPERATIVE EVALUATION FOR THE SURGEON
INDICATIONS FOR SURGICAL INTERVENTION
IMMEDIATE PERIOPERATIVE MANAGEMENT AND CONSIDERATIONS
SURGICAL APPROACH
SPECIAL CONSIDERATIONS
POSTOPERATIVE CONSIDERATIONS
SUGGESTED READINGS
Management of Pheochromocytoma
BACKGROUND
CLINICAL PRESENTATION
DIAGNOSIS
PREOPERATIVE MANAGEMENT
INTRAOPERATIVE CONSIDERATIONS
OPERATIVE TECHNIQUE
POSTOPERATIVE MANAGEMENT
MALIGNANT PHEOCHROMOCYTOMA AND PARAGANGLIOMA
SUMMARY
SUGGESTED READINGS
Management of Thyroid Nodules
INTRODUCTION
ULTRASONOGRAPHY
NONULTRASOUND THYROID INCIDENTALOMAS
OTHER TESTS IN EVALUATION OF THYROID NODULES
SIZE OF THYROID NODULE
BIOPSY
INDETERMINATE NODULES
MOLECULAR TESTING
MUTATIONAL ANALYSIS
SURGICAL MANAGEMENT
MANAGEMENT OF BENIGN NODULES WITH RADIOFREQUENCY ABLATION
CONCLUSION
SUGGESTED READINGS
Nontoxic Goiter
OVERVIEW
PATHOGENESIS
CLINICAL FEATURES
EVALUATION
INDICATIONS FOR TREATMENT
TREATMENT MODALITIES
POSTOPERATIVE CARE
SUGGESTED READINGS
Management of Thyroiditis
INTRODUCTION
HASHIMOTO THYROIDITIS
PAINLESS THYROIDITIS
DRUG-INDUCED THYROIDITIS
SUBACUTE (DE QUERVAIN) THYROIDITIS
REIDEL THYROIDITIS
ACUTE SUPPURATIVE THYROIDITIS
RADIOIODINE–INDUCED THYROIDITIS
SARS-CoV-2–INDUCED THYROIDITIS
SUGGESTED READINGS
Management of Hyperthyroidism
INITIAL EVALUATION
MEDICAL MANAGEMENT OF HYPERTHYROIDISM
SURGICAL MANAGEMENT OF HYPERTHYROIDISM
SPECIAL CONSIDERATIONS
ACKNOWLEDGMENTS
SUGGESTED READINGS
Surgical Management of Thyroid Cancer
BACKGROUND
DIAGNOSIS AND STAGING
OVERVIEW OF SURGICAL MANAGEMENT
TOTAL THYROIDECTOMY
SELECTIVE CERVICAL LYMPH NODE DISSECTION
SUGGESTED READINGS
Primary Hyperparathyroidism
BACKGROUND
DIAGNOSIS
PARATHYROIDECTOMY
OPERATIVE COMPLICATIONS
POSTOPERATIVE CONSIDERATIONS
SUGGESTED READINGS
Persistent and Recurrent Hyperparathyroidism
ETIOLOGY
DIAGNOSIS AND INDICATIONS FOR REOPERATIVE PARATHYROIDECTOMY
EVALUATION
LOCALIZATION STUDIES
PLANNING AND RISK ASSESSMENT
OPERATIVE TECHNIQUE
POSTOPERATIVE MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Surgical Management of Secondary and Tertiary Hyperparathyroidism
INTRODUCTION
PATHOPHYSIOLOGY
CLINICAL PRESENTATION
DIAGNOSIS
MEDICAL MANAGEMENT
PARATHYROIDECTOMY
ANATOMY
INDICATIONS FOR SURGERY
PREOPERATIVE MANAGEMENT
EXTENT OF SURGERY
POSTOPERATIVE MANAGEMENT AND COMPLICATIONS
SUMMARY
SUGGESTED READINGS
Metabolic Changes Following Bariatric Surgery
METABOLIC CONSEQUENCES OF OBESITY
METABOLIC IMPROVEMENTS AFTER WEIGHT LOSS SURGERY
METABOLIC SURGERY AND FUTURE DIRECTIONS
SUGGESTED READINGS
Cardiovascular Disease Risk Reduction After Bariatric Surgery
CARDIOVASCULAR DISEASE RISK FACTORS
CONCLUSION
SUGGESTED READINGS
Skin and Soft Tissue
Nonmelanoma Skin Cancers
BACKGROUND
RISK FACTORS AND PRECURSOR LESIONS
INITIAL EVALUATION OF SUSPECTED CUTANEOUS MALIGNANCY
BASAL CELL CARCINOMA
SQUAMOUS CELL CARCINOMA
SURGICAL EVALUATION AND TREATMENT
RISK PROGNOSTICATION
SURGICAL MANAGEMENT OF NONMELANOMA SKIN CANCER
NONSURGICAL MANAGEMENT OF NONMELANOMA SKIN CANCER
CONSIDERATIONS FOR METASTATIC DISEASE
OTHER MALIGNANT CUTANEOUS ENTITIES
Acknowledgment
SUGGESTED READINGS
Management of Cutaneous Melanoma
EPIDEMIOLOGY AND RISK FACTORS
MELANOMA, CLINICALLY AND PATHOLOGICALLY, DOES NOT HAVE SOLID DIAGNOSTIC CRITERIA
MELANOMA CLASSIFICATION
STAGING AND PROGNOSIS
INITIAL WORKUP
BIOPSY
SURGICAL MANAGEMENT OF PRIMARY CUTANEOUS MELANOMA
MANAGEMENT OF PATIENTS WITHOUT CLINICALLY SUSPICIOUS OR CLINICALLY POSITIVE NODES
NONSURGICAL MANAGEMENT OF LOW-VOLUME INVOLVEMENT IN SENTINEL LYMPH NODES
MANAGEMENT OF PATIENTS WITH CLINICALLY SUSPICIOUS OR POSITIVE NODES
MANAGEMENT OF RECURRENT MELANOMA
IMMUNOTHERAPY AND TARGETED THERAPY
SUGGESTED READINGS
Management of Soft Tissue Sarcomas
INTRODUCTION
ETIOLOGY
DIAGNOSTIC EVALUATION
TREATMENT
HISTOLOGY-SPECIFIC CONSIDERATIONS
SUMMARY
SUGGESTED READINGS
Management of Solitary Neck Mass
GENERAL PRINCIPLES
ANATOMIC CONSIDERATIONS
DIFFERENTIAL DIAGNOSIS
DIAGNOSTIC EVALUATION
MANAGEMENT
SUGGESTED READINGS
Surgical Infections of The Hand
BACKGROUND
GENERAL PRINCIPLES
EXAMINATION
TESTS AND IMAGING
TREATMENT
MINOR INFECTIONS
MAJOR INFECTIONS
OTHER INFECTIONS
NECROTIZING INFECTIONS
SUMMARY
SUGGESTED READINGS
Nerve Injury and Repair
BASIC ANATOMY
FASCICULAR TOPOGRAPHY
PATHOPHYSIOLOGY
TIMING
TREATMENT FOR NERVE INJURY
GENERAL PRINCIPLES
TECHNIQUES FOR NERVE SURGERY
EXPECTED OUTCOMES FROM REPAIR AND RECONSTRUCTION
WHO SHOULD OPERATE
SUMMARY
SUGGESTED READINGS
Necrotizing Skin and Soft Tissue Infections
INTRODUCTION
PATHOPHYSIOLOGY
DIAGNOSIS
TREATMENT
CONCLUSION
SUGGESTED READINGS
Chest Wall, Mediastinum, and Trachea
Management of Spontaneous and Secondary Pneumothorax
PNEUMOTHORAX
CLINICAL PRESENTATION
IMAGING
MANAGEMENT OF PNEUMOTHORAX
SUGGESTED READINGS
Management of Primary Chest Wall Tumors
OVERVIEW
DIAGNOSIS
CHEST WALL NEOPLASMS
SURGICAL TREATMENT OF CHEST WALL TUMORS
SUMMARY
SUGGESTED READINGS
Mediastinal Masses
APPROACH TO A PATIENT WITH A MEDIASTINAL MASS
ANTERIOR MEDIASTINAL MASSES
MIDDLE MEDIASTINAL MASSES
POSTERIOR MEDIASTINAL MASSES
SURGICAL APPROACHES
SUGGESTED READINGS
Primary Tumors of the Thymus
INTRODUCTION
CLINICAL PRESENTATION
IMAGING
TISSUE DIAGNOSIS
HISTOLOGIC CLASSIFICATION
STAGING
PRINCIPLES OF SURGERY
TRANS-STERNAL THYMECTOMY
MINIMALLY INVASIVE RESECTION
SYSTEMIC THERAPY
RADIATION THERAPY
SURVEILLANCE AND RECURRENCE
SUGGESTED READINGS
Management of Tracheal Stenosis
INTRODUCTION
INDICATIONS FOR TRACHEAL RESECTION
PREOPERATIVE ASSESSMENT
ANESTHESIA AND AIRWAY MANAGEMENT
SURGICAL TECHNIQHE FOR TRACHEAL RESECTION
COMPLICATIONS OF TRACHEAL SURGERY
RESULTS
SUGGESTED READINGS
Management of Acquired Esophageal Respiratory Tract Fistula
OVERVIEW
PATHOGENESIS
CLINICAL FEATURES
DIAGNOSIS
TREATMENT
OUTCOMES
SUMMARY
SUGGESTED READINGS
Repair of Pectus Excavatum
INTRODUCTION
EVALUATION OF PECTUS EXCAVATUM
OPERATIVE REPAIR
POSTOPERATIVE MANAGEMENT
EARLY COMPLICATIONS
LATE COMPLICATIONS
OUTCOMES
SUGGESTED READINGS
Vascular Surgery
Open Repair of Abdominal Aortic Aneurysms
PREOPERATIVE EVALUATION AND PLANNING FOR OPEN REPAIR
GENERAL PRINCIPLES OF OPEN REPAIR AND OPERATIVE PLANNING
TECHNICAL DETAILS OF OPERATION
SPECIAL CONSIDERATIONS IN OPEN REPAIR OF RUPTURED AAA
TREATMENT OUTCOMES WITH OPEN AAA REPAIR
SUGGESTED READINGS
Endovascular Treatment of Abdominal Aortic Aneurysms
PREOPERATIVE PLANNING
ASSESSING ACCESS VESSELS
PROXIMAL AORTIC SEAL
DISTAL ILIAC AND JUNCTIONAL SEAL
PATIENT SELECTION
PROCEDURAL STEPS
COMPLICATIONS
SUGGESTED READINGS
Management of Ruptured Abdominal Aortic Aneurysms
INTRODUCTION
PRESENTATION, DIAGNOSIS, AND INITIAL MANAGEMENT
ENDOVASCULAR VERSUS OPEN REPAIR
TECHNIQUE
COMPLICATIONS
FOLLOW-UP
CONCLUSION
SUGGESTED READINGS
Management of Abdominal Aortic Aneurysm with Concomitant Nonvascular Abdominal Pathology
GENERAL CONSIDERATIONS
ELECTIVE AORTIC ANEURYSM WITH ASYMPTOMATIC ABDOMINAL DISEASE
CHOLELITHIASIS
GASTROINTESTINAL MALIGNANCIES
EMERGENT AAA REPAIR AND CONCOMITANT DISEASE
SUMMARY
SUGGESTED READINGS
Management of Thoracic and Thoracoabdominal Aortic Aneurysms
INTRODUCTION
INDICATIONS FOR SURGERY
PATIENT SELECTION AND PREOPERATIVE RISK ASSESSMENT
STRATEGIES FOR THORACIC AND THORACOABDOMINAL AORTIC RECONSTRUCTION
ENDOVASCULAR MANAGEMENT OF DTAA and TAAA
SUGGESTED READINGS
Management of Acute Aortic Dissections
PRESENTATION AND DIAGNOSIS
CLASSIFICATION
MANAGEMENT
SUGGESTED READINGS
Carotid Endarterectomy
CLINICAL PRESENTATION
INDICATIONS FOR CEA
CEA: OPERATIVE TECHNIQUE
EXPOSURE FOR HIGH LESIONS
PERIOPERATIVE MEDICAL MANAGEMENT
RESULTS
SUGGESTED READINGS
Management of Recurrent Carotid Artery Stenosis
INTRODUCTION
INCIDENCE AND PRESENTATION OF RECURRENT CAROTID STENOSIS
RISK FACTORS FOR RECURRENT CAROTID STENOSIS
PATHOGENESIS OF RECURRENT CAROTID STENOSIS
SURVEILLANCE FOR RECURRENT CAROTID STENOSIS
MANAGEMENT OF RECURRENT STENOSIS AFTER CAROTID ENDARTERECTOMY
MANAGEMENT OF RECURRENT STENOSIS AFTER CAROTID ARTERY STENTING
SUMMARY
SUGGESTED READINGS
Balloon Angioplasty and Stents in Carotid Artery Occlusive Disease
BACKGROUND
PREPROCEDURAL CONSIDERATIONS
TRANSFEMORAL APPROACH FOR CAROTID ANGIOPLASTY
TRANSCAROTID APPROACH FOR CAROTID ANGIOPLASTY
PERIPROCEDURAL MANAGEMENT
FOLLOW-UP
SUMMARY AND PERSPECTIVE
SUGGESTED READINGS
Management of Aneurysms of the Extracranial Carotid and Vertebral Arteries
EXTRACRANIAL CAROTID ARTERY ANEURYSMS
EXTRACRANIAL VERTEBRAL ARTERY ANEURYSMS
SUGGESTED READINGS
Brachiocephalic Reconstruction
INTRODUCTION
CLINICAL PRESENTATION
DIAGNOSTIC EVALUATION
TREATMENT
ANATOMIC (DIRECT) REVASCULARIZATION
EXTRAANATOMIC (INDIRECT) REVASCULARIZATION
ARTERIAL TRANSPOSITION
ENDOVASCULAR TREATMENT
INNOMINATE ARTERY INTERVENTIONS
MANAGEMENT OF THE LEFT SUBCLAVIAN ARTERY FOR THORACIC AORTIC ENDOVASCULAR REPAIR
SUMMARY
SUGGESTED READINGS
Upper Extremity Arterial Occlusive Disease
ETIOLOGY
EVALUATION
MANAGEMENT
RESULTS OF TREATMENT
SUMMARY
SUGGESTED READINGS
Aortoiliac Occlusive Disease
INTRODUCTION
DIAGNOSTIC EVALUATION
MEDICAL TREATMENT
ENDOVASCULAR TREATMENT
SURGICAL TREATMENT
SUMMARY
SUGGESTED READINGS
Femoropopliteal Occlusive Disease
INTRODUCTION
OUR CLINICAL EVALUATION/IMAGING
TREATMENT
ENDOVASCULAR THERAPY FOR FEMOROPOPLITEAL DISEASE
CONCLUSION
SUGGESTED READINGS
Tibioperoneal Arterial Occlusive Disease
PATIENT ASSESSMENT
SELECTION OF INTERVENTION
SURGICAL BYPASS
ENDOVASCULAR REVASCULARIZATION
OTHER TECHNOLOGIES
POSTINTERVENTION MANAGEMENT AND SURVEILLANCE
COMPLICATIONS
FUTURE TREATMENT: CELL-BASED THERAPIES
SUGGESTED READINGS
Popliteal and Femoral Artery Aneurysm
FEMORAL ANEURYSM
POPLITEAL ANEURYSM
SUGGESTED READINGS
Treatment of Claudication
ASSESSMENT
TREATMENT
SUGGESTED READINGS
Pseudoaneurysms and Arteriovenous Fistulas
RISK FACTORS
ARTERIOVENOUS FISTULA
SUGGESTED READINGS
Management of Peripheral Arterial Thromboembolism
BACKGROUND/OVERVIEW
CLASSIFICATION, SITE, AND SOURCE OF EMBOLISM
CLINICAL PRESENTATION
DIAGNOSTIC EXAMINATION
MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Acute Peripheral Arterial and Bypass Graft Occlusion: Thrombolysis and Thrombectomy
BACKGROUND
INDICATIONS
IMAGING ASSESSMENT
SELECTION OF THERAPY
MECHANICAL THROMBECTOMY
SUGGESTED READINGS
Management of Infected Grafts
INTRODUCTION
DIAGNOSIS
TREATMENT
INFECTED STENT GRAFTS
INFECTED DIALYSIS ACCESS GRAFTS
CONCLUSION
SUGGESTED READINGS
Atherosclerotic Renal Artery Stenosis
INCIDENCE
NATURAL HISTORY
EVALUATION
TREATMENT
MEDICAL THERAPY
RENAL ARTERY STENOSIS SURVEILLANCE AND FOLLOW-UP
REVASCULARIZATION
ENDOVASCULAR THERAPY
COMPLICATIONS
OUTCOMES
SURVEILLANCE AND FOLLOW-UP
ENDOVASCULAR MANAGEMENT OF RESTENOSIS
OPEN SURGICAL REPAIRS
AORTORENAL ARTERY BYPASS
AORTORENAL ENDARTERECTOMY
EXTRAANATOMIC RECONSTRUCTION
COMPLICATIONS
RESULTS
SURVEILLANCE AND FOLLOW-UP
SUMMARY
SUGGESTED READINGS
Raynaud's Phenomenon
PRIMARY RAYNAUD'S PHENOMENON
SECONDARY RAYNAUD'SPHENOMENON
PATHOGENESIS
DIAGNOSIS
MANAGEMENT
SUMMARY
SUGGESTED READINGS
Thoracic Outlet Syndrome
INTRODUCTION
DIAGNOSIS AND TREATMENT
SURGICAL MANAGEMENT
SURGICAL OUTCOMES
CONCLUSION
SUGGESTED READINGS
Diabetic Foot
INTRODUCTION
CLASSIFICATION OF THE DIABETIC FOOT AND THREATENED LIMB
EVALUATION OF THE DIABETIC FOOT
TREATMENT OF THE DIABETIC FOOT
MULTIDISCIPLINARY MANAGEMENT, RESULTS OF TREATMENT, AND LONG-TERM PREVENTION
SUGGESTED READINGS
Gangrene of the Foot
INTRODUCTION
EPIDEMIOLOGY
CLINICAL EVALUATION
DIAGNOSTICS
MANAGEMENT
SUMMARY
SUGGESTED READINGS
Buerger's Disease (Thromboangiitis Obliterans)
INTRODUCTION/EPIDEMIOLOGY
PRESENTATION
DIAGNOSIS
TREATMENT
PROGNOSIS
SUMMARY
SUGGESTED READINGS
Takayasu's Arteritis
CLINICAL PRESENTATION
PATHOLOGY
THERAPY
SUMMARY
SUGGESTED READINGS
Acute Mesenteric Ischemia
ANATOMY
TREATMENT
OPEN INTERVENTIONS
OPEN EMBOLECTOMY
OPEN BYPASS
ANTEGRADE BYPASS
RETROGRADE BYPASS
RETROGRADE OPEN MESENTERIC STENTING
OPEN ENDARTERECTOMY
ENDOVASCULAR APPROACHES
POSTOPERATIVE CARE
LONG-TERM FOLLOW-UP
SUGGESTED READINGS
Chronic Mesenteric Ischemia
ETIOLOGY
DIAGNOSIS AND EVALUATION
REVASCULARIZATION OPTIONS
OUTCOMES
SUGGESTED READINGS
Hemodialysis Access Surgery
HISTORICAL NOTES
NATIONAL PRACTICES AND GUIDELINES
PREOPERATIVE EVALUATION
OPERATIVE TECHNIQUES
OPTIONS FOR NONCONVENTIONAL ACCESSES
CAUSES OF ACCESS FAILURE
CONCLUSION
SUGGESTED READINGS
Venous Thromboembolism: Prevention, Diagnosis, and Treatment
INTRODUCTION/IMPACT
RISK FACTORS
PREVENTION AND PROPHYLAXIS
DIAGNOSIS
DEEP VENOUS THROMBOSIS TREATMENT
PULMONARY EMBOLISM TREATMENT
INFERIOR VENA CAVA FILTERS
CONCLUSION
SUGGESTED READINGS
Vena Cava Filters
INTRODUCTION
INDICATIONS FOR INFERIOR VENA CAVA FILTER PLACEMENT
FILTER SELECTION
TECHNIQUE
FILTER RETRIEVAL
FILTER COMPLICATIONS
DISCUSSION
SUGGESTED READINGS
Treatment of Varicose Veins
INTRODUCTION
CLASSIFICATION AND ETIOLOGY
DIAGNOSIS
MANAGEMENT OF SUPERFICIAL VENOUS REFLUX
CONCLUSION
SUGGESTED READINGS
Lymphedema
ETIOLOGY
DIAGNOSIS
CONSERVATIVE MANAGEMENT
SURGICAL TREATMENT
SUMMARY
SUGGESTED READINGS
Lower Extremity Amputation
INDICATIONS
AMPUTATION TYPES
SELECTION OF AMPUTATION
POSTOPERATIVE MANAGEMENT AND COMPLICATIONS
OUTCOMES
CONCLUSION
Suggested Reading
Trauma and Emergency Care
Initial Assessment and Resuscitation of the Trauma Patient
INTRODUCTION
PRIMARY SURVEY
SECONDARY ASSESSMENT
SUMMARY
SUGGESTED READINGS
Prehospital Management of the Trauma Patient
LEVELS OF PREHOSPITAL CARE DELIVERY
INITIAL PREHOSPITAL MANAGEMENT OF THE CRITICALLY INJURED PATIENT
PREHOSPITAL PAIN MANAGEMENT
PREHOSPITAL TRIAGE
MODE OF TRANSPORTATION
EMS PATIENT HANDOFF
PREHOSPITAL TRAUMATIC ARREST
FUTURE DIRECTIONS
SUGGESTED READINGS
Use of Resuscitative Endovascular Balloon Occlusion of the Aorta in Resuscitation of the Trauma Patient
INTRODUCTION
INDICATIONS
CONTRAINDICATIONS
RISKS
TECHNICAL POINTS
PITFALLS
COMPLICATIONS
CONCLUSION
SUGGESTED READINGS
Airway Management in the Trauma Patient
RAPID CLINICAL AIRWAY ASSESSMENT: INDICATIONS FOR MANAGEMENT
OXYGEN THERAPY AND AIRWAY ADJUNCTS
RAPID-SEQUENCE INDUCTION AND INTUBATION
ENDOTRACHEAL INTUBATION
SUPRAGLOTTIC AIRWAY DEVICES
AWAKE FIBER-OPTIC INTUBATION
AIRWAY MANAGEMENT DECISION MAKING
SURGICAL AIRWAY
SUGGESTED READINGS
Surgeon's Use of Ultrasound in the Trauma and Critical Care Settings
INTRODUCTION
THE USE OF ULTRASOUND IN TRAUMA
USE OF ULTRASOUND IN SURGICAL CRITICAL CARE
THE USE OF ULTRASOUND IN THE ASSESSMENT OF INTRAVASCULAR VOLUME AND CARDIAC FUNCTION
SUMMARY
SUGGESTED READINGS
Emergency Department Resuscitative Thoracotomy
OVERVIEW
ANTEROLATERAL THORACOTOMY
PERICARDIOTOMY AND CARDIORRHAPHY
NONCARDIAC-RELATED THORACIC HEMORRHAGE
AORTIC CROSS-CLAMPING
APPROACH TO OPEN CARDIAC MASSAGE
RESUSCITATIVE ENDOVASCULAR BALLOON OCCLUSION OF THE AORTA
SUGGESTED READINGS
Management of Traumatic Brain Injury
INITIAL EVALUATION AND IMMEDIATE MANAGEMENT
MEDICAL MANAGEMENT
SURGICAL MANAGEMENT
OUTCOMES
SUGGESTED READINGS
Chest Wall Trauma, Hemothorax, and Pneumothorax
INITIAL EVALUATION
SPECIFIC INJURIES
SPECIAL CONSIDERATIONS IN PEDIATRIC CHEST TRAUMA
SUGGESTED READINGS
Management of Pulmonary Parenchymal Injury
INITIAL EVALUATION
ANATOMY
SPECIFIC INJURIES
TREATMENT
CONCLUSION
SUGGESTED READINGS
Blunt Abdominal Trauma
DIAGNOSTIC AND IMAGING ADJUNCTS
SPECIFIC CONSIDERATION FOR BLUNT TRAUMA
ADVANCEMENTS AND ONGOING CONTROVERSY IN BLUNT ABDOMINAL TRAUMA MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Penetrating Abdominal Trauma
TRANSPORT
MANAGEMENT IN THE EMERGENCY DEPARTMENT
TIMING OF LAPAROTOMY IN BUSY TRAUMA CENTERS
PATIENTS WITHOUT CLEAR-CUT INDICATIONS FOR LAPAROTOMY
SELECTIVE MANAGEMENT OF PATIENTS WITH PENETRATING ABDOMINAL TRAUMA
GENERAL PRINCIPLES OF TRAUMA LAPAROTOMY
SUMMARY
SUGGESTED READINGS
Management of Diaphragmatic Injuries
INTRODUCTION
EPIDEMIOLOGY
ANATOMY
DIAGNOSTIC WORKUP: BLUNT TRAUMA
DIAGNOSTIC WORKUP: PENETRATING TRAUMA
SURGICAL MANAGEMENT
PROGNOSIS
SUMMARY
SUGGESTED READINGS
Management of Traumatic Liver Injury
INTRODUCTION
INITIAL EVALUATION
NONOPERATIVE MANAGEMENT
OPERATIVE MANAGEMENT
MANAGEMENT AND COMPLICATIONS
CONCLUSION
SUGGESTED READINGS
Pancreatic and Duodenal Injuries
DUODENAL INJURIES
SURGICAL EXPOSURE OF THE PANCREAS
OUTCOMES AND COMPLICATIONS
CONCLUSION
SUGGESTED READINGS
Injuries to the Small and Large Bowel
INTRODUCTION
DIAGNOSTIC WORKUP
MANAGEMENT
SURGICAL TECHNIQUE
CONCLUSION
SUGGESTED READINGS
Current Management of Rectal Injury
INTRODUCTION
ANATOMIC CONSIDERATIONS
DIAGNOSIS
MANAGEMENT
COMPLICATIONS
SUGGESTED READINGS
Injured Spleen
NONOPERATIVE MANAGEMENT
SPLENORRHAPHY AND SPLENIC PRESERVATION
POSTSPLENECTOMY VACCINATION
RECOMMENDATIONS
SUGGESTED READINGS
Renal and Ureteral Traumatic Injuries
RETROPERITONEAL EVALUATION
RENAL
URETER
SUGGESTED READINGS
Tenets of Damage Control
INTRODUCTION
PHASE I: PREOPERATIVE DAMAGE CONTROL
PHASE II: INTRAOPERATIVE DAMAGE CONTROL
DAMAGE CONTROL THORACIC SURGERY
DAMAGE CONTROL VASCULAR SURGERY
PHASE III: POSTOPERATIVE CARE AND ONGOING RESUSCITATION
DEFINITIVE REPAIR
CLOSING REMARKS
SUGGESTED READINGS
Early Management of Pelvic Ring Disruption
EARLY MANAGEMENT OF PELVIc FRACTURES
IMMEDIATE ACTION SAVES LIVES: PRIMARY INTERVENTIONS
CONCLUSION
SUGGESTED READINGS
Urologic Complications of Pelvic Fracture
INITIAL EVALUATION
IMAGING
BLADDER INJURY
URETHRAL INJURY
CONCLUSION
SUGGESTED READINGS
Spine and Spinal Cord Injuries
INTRODUCTION AND EPIDEMIOLOGY
INITIAL EVALUATION AND MANAGEMENT
IMAGING
SELECTION OF SURGICAL CANDIDATES AND TIMING OF SURGERY
MEDICAL MANAGEMENT
COMPLICATIONS AND REHABILITATION
PROGNOSIS
SUGGESTED READINGS
Evaluation and Management of the Patient with Craniomaxillofacial Trauma
GENERAL CONCEPTS
EMERGENT MANAGEMENT OF CRANIOMAXILLOFACIAL TRAUMA
UPPER FACIAL INJURIES
TREATMENT OF UPPER FACIAL INJURIES
MIDFACIAL INJURIES
TREATMENT OF MIDFACE FRACTURES
LOWER FACIAL INJURIES
TREATMENT OF MANDIBLE FRACTURES
SOFT TISSUE INJURIES
CERVICAL SPINE AND INTRACRANIAL INJURIES
CONCLUSION
SUGGESTED READINGS
Penetrating Neck Trauma
EMERGENCY AIRWAY CHALLENGES
HEMOSTASIS OF EXTERNAL BLEEDING
URGENT OPERATION IN NONBLEEDING PATIENTS
URGENT DIAGNOSTIC EVALUATION
NECK EXPLORATION VERSUS OBSERVATION
OPERATIVE EXPOSURE
REPAIR OF SPECIFIC INJURIES
SUGGESTED READINGS
Blunt Cardiac Injury
INCIDENCE
MECHANISM OF INJURY AND PATHOPHYSIOLOGY
CLINICAL DIAGNOSIS OF BCI
BCI INJURY SEVERITY
TREATMENT OF BCI
COMMOTIO CORDIS
LONG-TERM FUNCTION AFTER BCI
ALGORITHM FOR DIAGNOSIS AND MANAGEMENT OF BCI
SUGGESTED READINGS
Abdominal Compartment Syndrome and Management of the Open Abdomen
INTRODUCTION AND PATHOPHYSIOLOGY
PREVENTION
DIAGNOSIS
SURGICAL INTERVENTION AND TECHNIQUE
MANAGEMENT OF THE OPEN ABDOMEN IN THE INTENSIVE CARE UNIT
COMPLICATIONS
CONCLUSION
SUGGESTED READINGS
Abdomen That Will Not Close
INDICATIONS FOR THE OPEN ABDOMEN
TEMPORARY CLOSURE TECHNIQUES
PERIOPERATIVE STRATEGIES FOR SUCCESS
SPECIAL CONSIDERATIONS
DEFINITIVE CLOSURE
CONCLUSION
SUGGESTED READINGS
Management of Vascular Injuries
INTRODUCTION
INITIAL EVALUATION AND PREPARATION
MANAGEMENT PRINCIPLES
OTHER CONSIDERATIONS FOR VASCULAR INJURY MANAGEMENT
SUGGESTED READINGS
Endovascular Management of Vascular Injuries
PREPAREDNESS
MANAGEMENT OF BLUNT THORACIC AORTIC INJURIES
PENETRATING AXILLOSUBCLAVIAN INJURIES
ENDOVASCULAR REPAIR OF TRACHEOINNOMINATE ARTERY FISTULA
RESUSCITATIVE ENDOVASCULAR BALLOON OCCLUSION OF THE AORTA
ENDOVASCULAR MANAGEMENT OF INADVERTENT ARTERIAL PLACEMENT OF VENOUS CATHETERS
SUGGESTED READINGS
Extremity Compartment Syndrome
CAUSES OF COMPARTMENT SYNDROME
DIAGNOSIS
ARM COMPARTMENT DECOMPRESSION
FOREARM COMPARTMENT SYNDROME
THIGH COMPARTMENT SYNDROME
LEG COMPARTMENT DECOMPRESSION
SELECTIVE COMPARTMENT DECOMPRESSION
ANTERIOR COMPARTMENT SYNDROME
CHRONIC EXERTIONAL COMPARTMENT SYNDROME
HAND AND FOOT COMPARTMENT DECOMPRESSION
POSTOPERATIVE MANAGEMENT
SUGGESTED READINGS
Burn Wound Management
EVALUATION
OPERATIVE CARE OF THE BURN WOUND
SUMMARY
SUGGESTED READINGS
Medical Management of the Burn Patient
INTRODUCTION
PHYSIOLOGIC CHANGES
INITIAL EVALUATION
INITIAL WOUND CARE
BURN EXCISION
RESUSCITATION
CRITICAL CARE
LONG-TERM FOLLOW-UP
SUGGESTED READINGS
Cold-Induced Injuries and Hypothermia
INTRODUCTION
SYSTEMIC HYPOTHERMIA: NONLOCALIZED COLD-INDUCED INJURY
LOCALIZED NONFREEZING AND FREEZING COLD-INDUCED INJURY
FROSTBITE
OUTCOMES IN FROSTBITE
SUGGESTED READINGS
Electrical and Lightning Injury
EPIDEMIOLOGY
PHYSICS (AND PATHOPHYSIOLOGY) OF ELECTRICAL INJURY
ELECTRICITY BASICS
PHYSICS AND PATHOPHYSIOLOGY OF ELECTRICAL INJURY
MANAGEMENT
PREHOSPITAL MANAGEMENT/SPECIAL CONSIDERATIONS
SURGICAL MANAGEMENT
SUGGESTED READINGS
Preoperative and Postoperative Care
Eras Protocols for General Surgery
INTRODUCTION
ERAS PATHWAY COMPONENTS
PREOPERATIVE CONSIDERATIONS
INTRAOPERATIVE CONSIDERATIONS
POSTOPERATIVE CONSIDERATIONS
POSTDISCHARGE CONSIDERATIONS
SUMMARY
SUGGESTED READINGS
Fluid and Electrolyte Therapy
FLUID COMPARTMENTS, DYNAMICS, AND OSMOLALITY
FLUID STATUS AND THE MANAGEMENT OF VOLUME THERAPY
DIAGNOSIS AND TREATMENT OF ELECTROLYTE DISORDERS
SUMMARY
SUGGESTED READINGS
Common Pediatric Surgical Emergencies
INTRODUCTION
PHYSIOLOGY AND ANESTHESIA IN CHILDREN
SUMMARY
SUGGESTED READINGS
A Practical Approach to Surgery in the Frail Elderly
PREOPERATIVE ASSESSMENT
OPERATIVE MODIFICATIONS FOR THE OLDER PATIENT
POSTOPERATIVE CARE
PREPARING FOR DISCHARGE AND RETURNING HOME
SUMMARY
SUGGESTED READINGS
Perioperative Optimization
TYPE 2 DIABETES MANAGEMENT: THE GOAL OF PERIOPERATIVE EUGLYCEMIA
Recommendations
CARDIOVASCULAR DISEASE
FRAILTY, MOBILITY, AND PREHABILITATION
NUTRITIONAL STATUS
SARS-COV-2 AND PERIOPERATIVE OPTIMIZATION
CONCLUSION
SUGGESTED READINGS
Is Nasogastric Intubation Necessary After Alimentary Tract Surgery?
HISTORICAL PERSPECTIVE
FOREGUT AND PANCREATIC SURGERY
COLORECTAL SURGERY AND ERAS
EMERGENCY SURGERY AND NASOGASTRIC TUBES
COMPLICATIONS OF NASOGASTRIC TUBES
WHY ARE SURGEONS STILL ROUTINELY USING NASOGASTRIC TUBES?
CONCLUSION
SUGGESTED READINGS
Surgical Site Infections
INTRODUCTION
EPIDEMIOLOGY
DEFINITION
RISK FACTORS
CLASSIFICATION
PREVENTION
TREATMENT
REMOTE MONITORING
SUMMARY
SUGGESTED READINGS
Management of Intraabdominal Infections
CLASSIFICATION
DIAGNOSIS
MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Epidemiology, Prevention, and Management of Occupational Exposure to Bloodborne Infections
INTRODUCTION
EPIDEMIOLOGY
PREVENTION
SUGGESTED READINGS
Antifungal Therapy in the Surgical Patient
SPECIFIC FUNGI
ANTIFUNGAL AGENTS
INVESTIGATIONAL AGENTS
COMMON FUNGAL INFECTIONS
INVASIVE FUNGAL INFECTIONS
FUNGAL INFECTIONS COMPLICATING BURN PATIENTS
FUNGAL RHINOCEREBRAL AND PULMONARY INFECTIONS
SUGGESTED READINGS
Use of Opioids in the Postoperative Period
THE OPIOID EPIDEMIC
OPIOID-RELATED ADVERSE EVENTS
NONOPIOID PAIN MANAGEMENT STRATEGIES
PREOPERATIVE EDUCATION AND ASSESSMENT OF PATIENT NEEDS
APPROPRIATE OPIOID PRESCRIBING
CHRONIC OPIOID USE AFTER SURGERY
DISPOSAL OF EXCESS OPIOID PILLS
METHODS TO DECREASE OPIOID PRESCRIBING
CONCLUSION
SUGGESTED READINGS
Management of Postoperative Delirium
INTRODUCTION
DEFINITION
DIAGNOSIS
RISK FACTORS
PRINCIPLES OF DELIRIUM PREVENTION
PRINCIPLES OF DELIRIUM MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Surgical Critical Care
COVID-19 and Health Care Delivery in a Pandemic
BACKGROUND
PATHOPHYSIOLOGY AND CLINICAL MANIFESTATIONS
DIAGNOSIS
MANAGEMENT
POSTDISCHARGE, PERIOPERATIVE, AND HEALTH SYSTEMS CONSIDERATIONS
SUMMARY
SUGGESTED READINGS
Surgical Palliative Care
INTRODUCTION: WHAT AND WHY SURGEONS SHOULD KNOW ABOUT PALLIATIVE CARE
DEFINITION OF PALLIATIVE CARE
WHEN TO CALL A PALLIATIVE CARE CONSULT—THE “SURPRISE QUESTION”
DIFFERENCES BETWEEN PALLIATIVE CARE AND HOSPICE
SPECIFIC SPECIALIST PALLIATIVE CARE MEASURES THAT CAN HELP THE SURGICAL ONCOLOGIST
PALLIATIVE PROCEDURES PERFORMED NEAR THE END OF LIFE
SUGGESTED READINGS
Cardiovascular Pharmacology
INTRODUCTION
ANTIPLATELET AGENTS
LIPID-LOWERING THERAPY
ANTICOAGULANTS
MEDICATIONS THAT IMPACT CARDIAC RHYTHM
INHALED DRUGS THAT CAUSE PULMONARY VASODILATION
VASOACTIVE DRUGS
CONCLUSION
SUGGESTED READINGS
Glucose Control in the Postoperative Period
INDICATIONS
THE THREE DOMAINS OF GLYCEMIC CONTROL: HYPOGLYCEMIA, HYPERGLYCEMIA, AND GLYCEMIC VARIABILITY
MANAGEMENT
CONCLUSION
SUGGESTED READINGS
Postoperative Respiratory Failure
INTRODUCTION
TYPES OF POSTOPERATIVE RESPIRATORY FAILURE
PREOPERATIVE RISK ASSESSMENT
PREVENTION OF PULMONARY COMPLICATION
INITIAL EVALUATION AND TREATMENT
SUGGESTED READINGS
Ventilator-Associated Pneumonia
INTRODUCTION
TERMINOLOGY/PATHOGENESIS
RISK FACTORS
PREVENTION
DIAGNOSIS
TREATMENT
CONCLUSION
SUGGESTED READINGS
Extracorporeal Membrane Oxygenation for Respiratory Failure
BACKGROUND
ECMO: INDICATIONS AND CONTRAINDICATIONS
ECMO SYSTEM COMPONENTS
TECHNIQUE
INITIATION OF VENOVENOUS ECMO
MANAGEMENT
TROUBLESHOOTING
VENOVENOUS ECMO WEANING
TERMINAL DECANNULATION
CONCLUSION
SUGGESTED READINGS
Tracheostomy
INTRODUCTION AND HISTORY
TRACHEAL ANATOMY
INDICATIONS, CONTRAINDICATIONS, AND TIMING
SURGICAL TRACHEOSTOMY
PERCUTANEOUS DILATATIONAL TRACHEOSTOMY
COMPLICATIONS
COMPARISON BETWEEN SURGICAL AND PERCUTANEOUS DILATATIONAL TRACHEOSTOMY
SUMMARY
SUGGESTED READINGS
Acute Kidney Injury in the Injured and Critically Ill
INTRODUCTION
EPIDEMIOLOGY
CLASSIFICATION AND STAGING OF AKI
AKI TRIGGERS
PATHOPHYSIOLOGY
PREVENTION OF AKI
MANAGEMENT STRATEGIES
RECOVERY AND OUTCOMES AFTER AKI
CONCLUSION
SUGGESTED READINGS
Acid-Base Disorders
HOMEOSTASIS AND BUFFERING SYSTEMS
ACID-BASE DISORDERS
APPROACH TO BLOOD GAS INTERPRETATION
STEPS TO ARTERIAL BLOOD GAS INTERPRETATION
METABOLIC ACIDOSIS
METABOLIC ALKALOSIS
RESPIRATORY ACIDOSIS
RESPIRATORY ALKALOSIS
MIXED ACID-BASE DISORDERS
SUGGESTED READINGS
Catheter Sepsis in the Intensive Care Unit
INTRODUCTION
SURVEILLANCE DEFINITIONS
INFECTION
MANAGEMENT
INFECTION PREVENTION
SUMMARY
SUGGESTED READINGS
Septic Response and Management
DEFINITION
DIAGNOSIS
TREATMENT
SUPPORTIVE TREATMENT ADJUNCTS
GOALS OF CARE
SUGGESTED READINGS
Multiple Organ Dysfunction and Failure
DYSFUNCTION AND FAILURE BY ORGAN SYSTEM
SPECIAL POPULATIONS
PALLIATIVE CARE AND ETHICS
SUMMARY
SUGGESTED READINGS
Antibiotics in Surgical Critical Care
HOSPITAL-ACQUIRED AND VENTILATOR-ASSOCIATED PNEUMONIA
COMMUNITY-ACQUIRED PNEUMONIA
ABDOMINAL SEPSIS
SURGICAL SITE INFECTIONS
NECROTIZING SOFT TISSUE INFECTIONS
VASCULAR ACCESS DEVICE–RELATED INFECTIONS
CATHETER-ASSOCIATED URINARY TRACT INFECTIONS
ANTIBIOTIC RESISTANCE
COVID-19
FUNGAL INFECTIONS
SUGGESTED READINGS
Endocrine Changes with Critical Illness
ADRENAL INSUFFICIENCY
HYPERGLYCEMIA
THYROIDAL DYSFUNCTION
SUGGESTED READINGS
Nutrition Therapy in the Critically Ill Surgical Patient
INTRODUCTION
CHANGES IN METABOLISM IN THE ACUTEly ILL OR SURGICAL PATIENT
MALNUTRITION
DETERMINATION OF NUTRITIVE NEEDS
ROUTES OF NUTRITION
SPECIAL CONSIDERATIONS
CONCLUSION
SUGGESTED READINGS
Coagulation Issues and the Trauma Patient
INTRODUCTION
OVERVIEW OF NORMAL HEMOSTASIS
TRAUMA-INDUCED COAGULOPATHY
CLINICAL ASSESSMENT OF TIC
MANAGEMENT OF TRAUMA-INDUCED COAGULOPATHY
BLOOD PRODUCT MANAGEMENT
RECOMMENDED APPROACH TO TRAUMA-ASSOCIATED BLEEDING
TRAUMA-INDUCED COAGULOPATHY IN CHILDREN
SUGGESTED READINGS
Post–Intensive Care Syndrome
INTRODUCTION
PHYSICAL IMPAIRMENT
COGNITIVE IMPAIRMENT
PSYCHOLOGICAL IMPAIRMENT
PREVENTION OF PICS
CAREGIVER BURDEN
POST-ICU CLINICS
ONGOING CLINICAL TRIALS
CONCLUSION
SUGGESTED READINGS
Index

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