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Surgical decision making. 2nd edition
BOOK REVIEWS
Surgwal Diseases of the Pleura and Chest Wall By R
Maurice Hood, Karen Antman, Arthur Boyd, David Naldlch, and Richard Shemm Philadelphia WB Saunders, 1986 288pages $4995 This monograph 1s designed to reach and instruct students and residents m thoraclc surgery By both design and content, I think the authors have done an excellent Job m presenting the material to their audience The text reviews, as well as possible, not only the surglcal anatomy, but the radlologlc anatomy as viewed by the thoraclc surgeon It 1s certainly true, as stated by the authors, that many of the disease complexes that affect the pleural space and chest wall are uncommon today, and this requires careful emphasis so that one will not mlsmanage these diseases when they are encountered Consequently, knowledge of management of pleural mfectlons continues to be extremely important to the thoraclc surgeon and should equal that of today’s pulmonologlst Also reviewed quite nicely are postoperative comphcatlons, including management of empyema, bronchopleural flstula, and pleural space problems This section 1s lmportant to all thoraclc surgery residents The authors also included a separate section on chylothorax and spontaneous pneumothorax, which 1s up-to-date Management of malignant pleural condltlons are covered as well I have only one concern and that 1s with regard to the treatment section where an mordmate amount of time IS spent on extrapleural pneumonectomy for malignant mesothehoma, a procedure I believe 1s rarely indicated, if at all Tumors of the chest wall can be one of the most comphcated problems facing the thoraclc surgeon I am sure the authors would agree that the section on their management could have been expanded, as mismanagement can be a slgmflcant problem The newer techniques m chest wall reconstruction are presented, however They are lmportant m the management of chronic empyema as well as m reconstruction of the chest wall after resection of large masses As with many monographs of this type, it 1s difficult to cover every topic completely However, I believe that the text will be helpful to thoraclc surgeons working out a management plan for patients with complex problems mvolvmg the chest wall and pleura Walter G Wolfe, MD Durham, North Carolina
MaJor Ambulatory Surgery. By James E Davis Baltlmore Wdhams and Wilkins, 1986
With a keen interest and an extensive experience m ambulatory surgery, Dr Davis has brought together much mformatlon for those plannmg to develop a maJor ambulatory surgical unit and for those who will practice m such a facility He first presents a history of surgery with em-
Volume153,Apil1937
phasis on ambulatory care of the patient and then a history of major ambulatory surgery, followed by a chapter on its present status A detailed presentation on development, planning and design, and management and staffmg of the unit 1s also included Surgical and anesthesia conslderatlons precede a section on the surgical speclalties utlhzmg the unit The contrlbutmg authors, each a speclahst m a particular area, list the types of patient they admit and describe some of the techniques useful for surgery m this setting The section 1s easy to read and understand The chapter on plastic and reconstructive surgery 1s too long and repeats admn-nstratlve data presented m the previous chapters In the section entitled “Special Conslderatlons,” payment, legal issues, marketmg, accredltlon, and a description of the North Carolina Blue Cross-Blue Shield plan for increasing ambulatory surgery use are presented m detail and provide useful mformatlon for planners and admmlstrators The final chapter describes the future The book 1swell written, the type 1s easily read, and the mformatlon presented will be useful to health planners and to the admmlstrator-surgeon interested m major ambulatory surgery Thaddeus M fdoseley, MD Jacksonville, FIorda
Surgical Decmon Making 2nd edition Edited by Lawrence W Norton, and Ben Elseman Philadelphia WB Saunders, 1985 368 pages $49 95
The second edition of this text surpasses the well-received first edition m estabhshmg the place of the logic-dictated algorthmlc approach to the diagnosis and management of surgical illnesses Several noteable changes have occurred, making this second edition an almost entirely new endeavor The list of 119 contributors now includes many of the leading mvestlgators m each field of interest, which enables the reader to follow the thought processes of acknowledged experts as they approach the variables m a given chmcal problem Further, the format has been standardized from topic to topic, thus allowing the reader easy transltlons between subjects of study This format meludes reference lists, data bases, and explanations of the declslon-making process on the left hand pages while the algorithms are Juxtaposed on the right When the explanatory paragraphs are too long for the space provided, their contmuatlon on the next page 1saccompanied by a copy of the algorithm, thus obviating the need for backtracking to fmd one’s place m the algorithm The subject matter of this text IS far-reaching Ten general topics, for example, cardiopulmonary resuscltatlon, bleeding disorders, frostbite, and postoperative fevers, are presented along with multiple topics under each of the chapter headings “Head and Neck,” “Thorax,” “Abdomen,” “ Vascular System, ” “Breast and Soft Tls-
417
Book Reviews
sue ” “Endocrme System,” “Pedlatrlcs,” “Urology,” “G&ecology,” and “Orthopedics ” In each chapter, two mam approaches are used Algorithms elucldatmg the approach to a presenting symptom or ugn, such as neck mass or upper gastromtestmal bleeding, are included along with those deplctmg the thought processes mvolved m managing a specific disease entity, such as laryngeal cancer or duodenal ulcer As stated m the preface, this text IS designed to allow a student at any level of sophlstlcatlon the abdlty to follow the logic of an informed expert The disadvantages to this format are the bare-bones approach to the study of patient care, which must be supplemented with the references provided or a standard textbook of surgery, and the fact that algorithms are not directly transferrable to the chmcal arena Overall, the text provides a clear, but hmlted, overvlew of the approach to numerous chmcal problems We heartily recommend It to both the student and the resident Melvyn P Karp, MD Lewis M Flint, MD Buffalo, New York
Reoperatwe Surgery of the Abdomen Edlted by Donald E Fry New York Marcel Dekker, 1986 431 pages $69 75 This book, the sixth m a series of volumes devoted to the science and practice of surgery, contains 22 chapters related to various phases of reoperatlve abdominal surgery Nearly 30 contrlbutmg authors were selected from a wide range of surgical specialties, as well as from the fields of endoscopy and radlology They examme m detail many perplexing problems related to an extremely difficult category of abdommal surgery-second procedures that follow after the first ones have faded It IS not surprlsmg that the chapters vary considerably m form and content The great maJor&y are excellent and Include well-balanced dlscusslons of each topic Of the numerous examples that could be chosen, one of the ploneers In percutaneous drainage of abdommal abscesses provides a welcome conservative approach A complementary chapter on surgical drainage completes an excellent dlscusslon of this controversial problem On the other hand, occasionally an author’s particular point of view stands unchallenged For instance, percutaneous gastrostomy certamly IS successful
m the hands of the expert
endoscoplsts who have devised the method they desmbe, however, this nonoperatlve method may be dangerous compared with surgical gastrostomy m some geographic locahties Other difficult problems are discussed m chapters that are commendable The sections on gastric surgery, reoperatlons for esophageal reflux, vascular disease, and portal hypertension furnish exphclt mdlcatlons and dlrectlons for required secondary procedures In fact, nearly
418
every presentation contams valuable mformatlon For example, a careful retrospective study of secondary operatlons 1sdescribed m detad Among the numerous concluslons IS the unwelcome news that recovery from reoperatlon m the elderly 1s very rare The reader should not expect to fmd a comprehensive analysis of all of the problems encountered m reoperatlve abdominal surgery Indeed, many diseases that are followed by secondary procedures, such as pancreatltls, Crohn’s disease, or the mundane ventral hermas, are elther not dlscussed or are consldered only brlefly In reahty, these problems are encountered commonIy by community surgeons On the other hand, the mcluslon of such chapters as those on reoperatlon for faded renal transplantation and the emphasis on endoscopy suggest that the book would be directed more appropriately to surgeons practlcmg m academic centers, but It 1s much more likely that the intent of the editors has been to choose topics m which recent developments have arlsen Certamly, the references are oriented strongly to recent pubhcatlons Readers, therefore, will be supphed with a wealth of mformatlon and also ~111discover methods of salvage by many procedures that are now m the vanguard of modern abdommal surgery Claude E Welch, MD Boston, Massachusetts
Acute Peripheral Vascular Surgery By Michael Staudocher New York Springer-Verlag, 1985 165 pages $38 50 This book, as outhned m the preface, 1s designed for the surgeon who has very little trammg or experience m vascular surgery but who occasionally may be mvolved by necessity in dealing with a vascular emergency The first part of the book deals with the defmltlon of a vascular emergency, the mmlmum mstruments necessary to manage these emergencies, and some basic vascular surgical techniques The second half of the book covers a variety of vascular emergencies that a general surgeon may encounter There are some very good basic prmclples outlmed, and the lllustratlons accompanymg the dlscusslons are well done, simple, and easy to foIlow Although most vascular emergencies are covered, the author neglects to discuss one of the more common ones, that bemg ruptured abdominal aortlc aneurysm I do not recommend that medlcal students purchase this book as It IS more an atlas than a book on dlagnosls and pathophyaology Residents m trammg and surgeons with some experience m vascular surgery may also not fmd this book useful since it deals with many problems on a superficial level Due to Its readabrhty and well done illustrations, the book may be valuable to surgeons who are only occasionally faced with a vascular emergency Frank B Miller, MD LoumIle, Kentucky
The American Journal of Surgery
Surgwal Diseases of the Pleura and Chest Wall By R
Maurice Hood, Karen Antman, Arthur Boyd, David Naldlch, and Richard Shemm Philadelphia WB Saunders, 1986 288pages $4995 This monograph 1s designed to reach and instruct students and residents m thoraclc surgery By both design and content, I think the authors have done an excellent Job m presenting the material to their audience The text reviews, as well as possible, not only the surglcal anatomy, but the radlologlc anatomy as viewed by the thoraclc surgeon It 1s certainly true, as stated by the authors, that many of the disease complexes that affect the pleural space and chest wall are uncommon today, and this requires careful emphasis so that one will not mlsmanage these diseases when they are encountered Consequently, knowledge of management of pleural mfectlons continues to be extremely important to the thoraclc surgeon and should equal that of today’s pulmonologlst Also reviewed quite nicely are postoperative comphcatlons, including management of empyema, bronchopleural flstula, and pleural space problems This section 1s lmportant to all thoraclc surgery residents The authors also included a separate section on chylothorax and spontaneous pneumothorax, which 1s up-to-date Management of malignant pleural condltlons are covered as well I have only one concern and that 1s with regard to the treatment section where an mordmate amount of time IS spent on extrapleural pneumonectomy for malignant mesothehoma, a procedure I believe 1s rarely indicated, if at all Tumors of the chest wall can be one of the most comphcated problems facing the thoraclc surgeon I am sure the authors would agree that the section on their management could have been expanded, as mismanagement can be a slgmflcant problem The newer techniques m chest wall reconstruction are presented, however They are lmportant m the management of chronic empyema as well as m reconstruction of the chest wall after resection of large masses As with many monographs of this type, it 1s difficult to cover every topic completely However, I believe that the text will be helpful to thoraclc surgeons working out a management plan for patients with complex problems mvolvmg the chest wall and pleura Walter G Wolfe, MD Durham, North Carolina
MaJor Ambulatory Surgery. By James E Davis Baltlmore Wdhams and Wilkins, 1986
With a keen interest and an extensive experience m ambulatory surgery, Dr Davis has brought together much mformatlon for those plannmg to develop a maJor ambulatory surgical unit and for those who will practice m such a facility He first presents a history of surgery with em-
Volume153,Apil1937
phasis on ambulatory care of the patient and then a history of major ambulatory surgery, followed by a chapter on its present status A detailed presentation on development, planning and design, and management and staffmg of the unit 1s also included Surgical and anesthesia conslderatlons precede a section on the surgical speclalties utlhzmg the unit The contrlbutmg authors, each a speclahst m a particular area, list the types of patient they admit and describe some of the techniques useful for surgery m this setting The section 1s easy to read and understand The chapter on plastic and reconstructive surgery 1s too long and repeats admn-nstratlve data presented m the previous chapters In the section entitled “Special Conslderatlons,” payment, legal issues, marketmg, accredltlon, and a description of the North Carolina Blue Cross-Blue Shield plan for increasing ambulatory surgery use are presented m detail and provide useful mformatlon for planners and admmlstrators The final chapter describes the future The book 1swell written, the type 1s easily read, and the mformatlon presented will be useful to health planners and to the admmlstrator-surgeon interested m major ambulatory surgery Thaddeus M fdoseley, MD Jacksonville, FIorda
Surgical Decmon Making 2nd edition Edited by Lawrence W Norton, and Ben Elseman Philadelphia WB Saunders, 1985 368 pages $49 95
The second edition of this text surpasses the well-received first edition m estabhshmg the place of the logic-dictated algorthmlc approach to the diagnosis and management of surgical illnesses Several noteable changes have occurred, making this second edition an almost entirely new endeavor The list of 119 contributors now includes many of the leading mvestlgators m each field of interest, which enables the reader to follow the thought processes of acknowledged experts as they approach the variables m a given chmcal problem Further, the format has been standardized from topic to topic, thus allowing the reader easy transltlons between subjects of study This format meludes reference lists, data bases, and explanations of the declslon-making process on the left hand pages while the algorithms are Juxtaposed on the right When the explanatory paragraphs are too long for the space provided, their contmuatlon on the next page 1saccompanied by a copy of the algorithm, thus obviating the need for backtracking to fmd one’s place m the algorithm The subject matter of this text IS far-reaching Ten general topics, for example, cardiopulmonary resuscltatlon, bleeding disorders, frostbite, and postoperative fevers, are presented along with multiple topics under each of the chapter headings “Head and Neck,” “Thorax,” “Abdomen,” “ Vascular System, ” “Breast and Soft Tls-
417
Book Reviews
sue ” “Endocrme System,” “Pedlatrlcs,” “Urology,” “G&ecology,” and “Orthopedics ” In each chapter, two mam approaches are used Algorithms elucldatmg the approach to a presenting symptom or ugn, such as neck mass or upper gastromtestmal bleeding, are included along with those deplctmg the thought processes mvolved m managing a specific disease entity, such as laryngeal cancer or duodenal ulcer As stated m the preface, this text IS designed to allow a student at any level of sophlstlcatlon the abdlty to follow the logic of an informed expert The disadvantages to this format are the bare-bones approach to the study of patient care, which must be supplemented with the references provided or a standard textbook of surgery, and the fact that algorithms are not directly transferrable to the chmcal arena Overall, the text provides a clear, but hmlted, overvlew of the approach to numerous chmcal problems We heartily recommend It to both the student and the resident Melvyn P Karp, MD Lewis M Flint, MD Buffalo, New York
Reoperatwe Surgery of the Abdomen Edlted by Donald E Fry New York Marcel Dekker, 1986 431 pages $69 75 This book, the sixth m a series of volumes devoted to the science and practice of surgery, contains 22 chapters related to various phases of reoperatlve abdominal surgery Nearly 30 contrlbutmg authors were selected from a wide range of surgical specialties, as well as from the fields of endoscopy and radlology They examme m detail many perplexing problems related to an extremely difficult category of abdommal surgery-second procedures that follow after the first ones have faded It IS not surprlsmg that the chapters vary considerably m form and content The great maJor&y are excellent and Include well-balanced dlscusslons of each topic Of the numerous examples that could be chosen, one of the ploneers In percutaneous drainage of abdommal abscesses provides a welcome conservative approach A complementary chapter on surgical drainage completes an excellent dlscusslon of this controversial problem On the other hand, occasionally an author’s particular point of view stands unchallenged For instance, percutaneous gastrostomy certamly IS successful
m the hands of the expert
endoscoplsts who have devised the method they desmbe, however, this nonoperatlve method may be dangerous compared with surgical gastrostomy m some geographic locahties Other difficult problems are discussed m chapters that are commendable The sections on gastric surgery, reoperatlons for esophageal reflux, vascular disease, and portal hypertension furnish exphclt mdlcatlons and dlrectlons for required secondary procedures In fact, nearly
418
every presentation contams valuable mformatlon For example, a careful retrospective study of secondary operatlons 1sdescribed m detad Among the numerous concluslons IS the unwelcome news that recovery from reoperatlon m the elderly 1s very rare The reader should not expect to fmd a comprehensive analysis of all of the problems encountered m reoperatlve abdominal surgery Indeed, many diseases that are followed by secondary procedures, such as pancreatltls, Crohn’s disease, or the mundane ventral hermas, are elther not dlscussed or are consldered only brlefly In reahty, these problems are encountered commonIy by community surgeons On the other hand, the mcluslon of such chapters as those on reoperatlon for faded renal transplantation and the emphasis on endoscopy suggest that the book would be directed more appropriately to surgeons practlcmg m academic centers, but It 1s much more likely that the intent of the editors has been to choose topics m which recent developments have arlsen Certamly, the references are oriented strongly to recent pubhcatlons Readers, therefore, will be supphed with a wealth of mformatlon and also ~111discover methods of salvage by many procedures that are now m the vanguard of modern abdommal surgery Claude E Welch, MD Boston, Massachusetts
Acute Peripheral Vascular Surgery By Michael Staudocher New York Springer-Verlag, 1985 165 pages $38 50 This book, as outhned m the preface, 1s designed for the surgeon who has very little trammg or experience m vascular surgery but who occasionally may be mvolved by necessity in dealing with a vascular emergency The first part of the book deals with the defmltlon of a vascular emergency, the mmlmum mstruments necessary to manage these emergencies, and some basic vascular surgical techniques The second half of the book covers a variety of vascular emergencies that a general surgeon may encounter There are some very good basic prmclples outlmed, and the lllustratlons accompanymg the dlscusslons are well done, simple, and easy to foIlow Although most vascular emergencies are covered, the author neglects to discuss one of the more common ones, that bemg ruptured abdominal aortlc aneurysm I do not recommend that medlcal students purchase this book as It IS more an atlas than a book on dlagnosls and pathophyaology Residents m trammg and surgeons with some experience m vascular surgery may also not fmd this book useful since it deals with many problems on a superficial level Due to Its readabrhty and well done illustrations, the book may be valuable to surgeons who are only occasionally faced with a vascular emergency Frank B Miller, MD LoumIle, Kentucky
The American Journal of Surgery