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Recent Advances in Surgery—11
Roshan Lall Gupta
1:
Glimpses of Progress in Surgery
STEM CELL RESEARCH
Embryonic Stem Cells
Stem Cell Directed Gene Therapy in the Fetus
Postnatal Stem Cell Therapy for SCID (Severe Combined Immunodeficiency)
Adult Stem Cells
Other Sources for Stem Cells
Hepatocyte Transplantation
REFERENCES
CARDIAC REGENERATION WITH ADULT STEM CELLS
REFERENCES
STEM CELLS AND BRAIN REPAIR
REFERENCES
ILEAL STEM CELL TRANSPLANTATION
REFERENCES
CERTAIN PROBLEMS WITH THE THERAPEUTIC USE OF STEM CELLS
TISSUE ENGINEERING
REFERENCES
SPINAL CORD INJURY
REFERENCES
SHORTAGE OF ORGANS FOR TRANSPLANTATION
Kidney Transplantation
Liver Transplantation
REFERENCES
ENDOVENOUS MANAGEMENT OF VARICOSE VEINS
REFERENCES
COMPLICATIONS OF VASCULAR ACCESS IN HEMODIALYSIS FOR ENDSTAGE RENAL DISEASE
Thrombosis
Aneurysm Formation
Pseudoaneurysm
Steal Syndrome6
Extravasation Injury
Infection
REFERENCES
FEMOROPOPLITEAL ATHEROSCLEROTIC ARTERIAL DISEASE
Smoking and Exercise
Lipid Lowering Therapy
Pharmacologic Therapy
Gene Therapy
Angioplasty and Stenting
Atherectomy
Laser-assisted Angioplasty
Brachytherapy
Cryotherapy
Exercise Versus Angioplasty
REFERENCES
AORTO-ARTERITIS, AN INDIAN EXPERIENCE
REFERENCES
RADIATION INJURY AND THE SURGEON
The Gastrointestinal Syndrome
REFERENCES
TERROR RELATED INJURIES
REFERENCES
TRAUMA CARE
REFERENCES
RANDOMIZED CONTROLLED TRIALS IN SURGERY
REFERENCES
NOSOCOMIAL (HOSPITAL ACQUIRED) INFECTIONS
REFERENCES
USE OF FIBRIN SEALANT IN SURGERY
Use in General Surgery
Use in Vascular Surgery
Use in Neurosurgery
Use in Thoracic Surgery
Use in Urology10
Use in Hepatic Surgery
REFERENCES
BIORESORBABLE FIXATION DEVICES FOR MUSCULOSKELETAL INJURIES IN ADULTS
REFERENCES
PREVENTION OF OSTEOPOROTIC FRACTURES IN POSTMENOPAUSAL WOMEN-NATIONAL INSTITUTE OF CLINICAL EXCELLENCE (NICE) GUIDELINES
REFERENCES
PHOTODYNAMIC THERAPY (PDT)
REFERENCES
LAPAROSCOPIC EXPLORATION OF THE COMMON BILE DUCT WITH PRIMARY CLOSURE
REFERENCES
MINIMALLY INVASIVE SURGERY (MIS) VS OPEN OPERATION FOR COLORECTAL RESECTION
REFERENCES
TREATMENT OPTIONS IN ACHALASIA CARDIA
REFERENCES
BILIARY ATRESIA
REFERENCES
SHORT BOWEL SYNDROME
REFERENCES
ABDOMINAL COMPARTMENT SYNDROME
REFERENCES
AROMATASE INHIBITORS: AN OVERVIEW
REFERENCES
THE MOLECULAR APPROACH TO TREATMENT OF CANCER
REFERENCES
2:
Gene Disorders in Pediatric Surgery Practice
SOME DEFINITIONS
Evaluation for detection of congenital anomalies
Genetic History
Prenatal History
Obstetric history
Family History
Clinical examination
DIAGNOSIS
MANAGEMENT WITH EMPHASIS ON GENETIC COUNSELING
A. Neural tube defect (NTD)
Antenatal screening for Neural tube defect
B. Cleft lip/palate
C. Hydrocephalus5,6
D. Congenital Diaphragmatic Hernia (CDH)
E. Anterior abdominal wall defects5
F. Esophageal and intestinal atresia including tracheo-esophageal fistula (TOF)
G. Hirschsprung disease
H. Ano-rectal malformations (ARMS)5
Sporadic
Single gene disorders
Chromosomal
I. Renal Tract Anomalies5,8–10
Management (Mx) and counseling
J. Ambiguous genitalia
K. Hypospadias5
Important genetic disorders with hypospadias
Special Investigations
CONCLUSIONS
REFERENCES
3:
Recent Advances in Interventional Radiology
VASCULAR INTERVENTIONAL RADIOLOGY
Peripheral Vascular disease (PVD)
Interventional Radiology in Iliac disease
Interventional Radiology in Femero-popliteal disease
Interventional Radiology in Below Knee Disease
Interventional Radiology of the aorta
Interventional Radiology in Visceral Arteries
Interventional Radiology in the carotid arteries
GASTROINTESTINAL INTERVENTIONAL RADIOLOGY
Gastrointestinal stenting
Radiological Gastrostomies
Hepatobiliary intervention
Interventional Radiology in Urology
Interventional radiology in Obstetrics and Gynecology
INTERVENTIONAL ONCOLOGY
Venous Procedures in interventional Radiology
Transjugular Intrahepatic Porto-systemic Shunt (TIPSS)
CONCLUSION
4:
Role of Radioisotopes in Management of Endocrine Disease
PARATHYROID
ADRENAL GLAND DISORDERS
Adrenals
ADRENAL INCIDENTALOMA
Neuro-endocrine Tumors
THERAPY WITH ISOTOPES
THYROID
Graves' Disease
Thyroid Adenocarcinoma (Differentiated)
Medullary Carcinoma Thyroid
PARATHYROID
GASTROINTESTINAL NEUROENDOCRINE TUMORS
5:
Metabolic Syndrome—Surgical Management
INTRODUCTION
METABOLIC SYNDROME (MS)
OBESITY AND DISTRIBUTION OF ADIPOSE TISSUE1,5,6
PREVALENCE OF THE METABOLIC SYNDROME - ETHNIC DIFFERENCES
Combined Genetic and Environmental Influences
The Entero-endocrine System and the Adipostatic Mechanism
Adipocytokines in the Pathogenesis of Metabolic Syndrome16 (Fig. 5.1)
Metabolic Syndrome – Is There a Cure?
Bariatric Surgery for Diabetes Mellitus and Metabolic Syndrome
Type 2 Diabetes – Is it an Operable Intestinal Disease?
The Entero-Insular Axis and Incretin Effect
The “Anti-incretin” Theory
How does Bariatric Surgery Effect Type 2 DM?28,30,31
The “hypothesis of the distal bowel”
“Hypothesis of the proximal intestine” (Fig. 5.5)
From “Bariatric Surgery” to “Metabolic Surgery”
Implantable Gastric Stimulation (IGS) System for Treatment of Type 2 Diabetes
System Components
(Tantalus Implantable pulse generator, Metacure, United States)
Potential Mechanisms of Action
The Procedure
Metabolic Surgery: Future Trends
ACKNOWLEDGEMENT
6:
An Update on Laparoscopy
INTRODUCTION
DIAGNOSTIC LAPAROSCOPY
Access to Peritoneum—Open or Veress?5,6
Inguinal Hernia Repair
GALLBLADDER—SILENT GALLSTONES14
Needle and Trocar Injuries15–17
Bowel Injury in Gynecology Laparoscopy
Infections in Laparoscopy19,20
Appendix
Intestinal Infections
Colorectal Cancer
Immunity Response38–40
Stomach41–46
Pancreas47–49
Liver
Acute Abdomen
Abdominal Trauma
Notes—Natural Orifice Transluminal Endoscopic Surgery69–73
Obesity
Training-Laparoscopy Skills
7:
Molecular Targeted Therapy in Treatment of Cancer
RITUXIMAB (MABTHERA)
Indication
Mechanism of Action
Dosage and Administration
Adverse Reactions
TRASTUZUMAB (HERCEPTIN)
Indication
Mechanism of Action
Dosage and Administration
Adverse Reactions
Precautions
CETUXIMAB (ERBITUX)
Indications
Mechanism of Action
Dosage and Administration
Adverse Reactions
PANITUMUMAB (VECTIBIX)
Indications
Mechanism of Action
Dosage and Administration
Adverse Reactions
BEVACIZUMAB (AVASTIN)
Indications
Mechanism of Action
Dosage and Administration
Adverse Reactions
ALEMTUZUMAB (CAMPATH)
Indiacation
Mechanism of Action
Dosage and Administration
Adverse Reactions
GEMTUZUMAB OZOGAMICIN (MYLOTARG)
Mechanism of Action
Indications
Dosage and Administration
Adverse Effects
DENILEUKIN DIFTITOX (ONTAK)
Mechanism of Action
Indications
Dosage and Administration
Adverse Reactions
TOSITUMOMAB (BEXXAR)
Mechanism of Action
Indications
Dosage and Administration
Adverse Reactions
IBRITUMOMAB (ZEVALIN)
Mechanism of Action
Indications
Dosage and Administration
Phase1
Phase 2 (7–9 days following phase 1)
Adverse Reactions
TYROSINE KINASE INHIBITORS (TKI)
IMATINIB (GLEEVEC)
Mechanism of Action
Indications
Dosage and Administration
Adverse Effects
SORAFENIB (NEXAVAR)
Indications
Dosage
Adverse Reactions
SUNITINIB (SUTENT)
Mechanism of Action
Dosage and Administration
Indications
Adverse Reactions
GEFITINIB (IRESSA)
Mechanism of Action
Dosage and Administration
Indications
Adverse Reactions
ERLOTINOB (TARCEVA)
Mechanism of Action
Indications
Dosage and Administration
Adverse Effects
DASATINIB (SPRYCEL)
Mechanism of Action
Indications
Dosage and Administration
Adverse Reactions
BORTEZOMIB (VELCADE)
Mechanism of Action
Indications
Dosage and Administration
Adverse Reactions
8:
Neonatal Hyperbilirubinemia
9:
An Approach to Carcinoma Gallbladder
INTRODUCTION
Applying Knowledge from the Laboratory to the Clinic
How do Patients Present with Gallbladder Cancer?
How do we Investigate such a Patient?
Ultrasonography (USG)
Computed Tomography (CT) of the Abdomen and Pelvis
Magnetic Resonance Imaging (MRI) and Magnetic Resonance Cholangio-pancreatography (MRCP)
Functional Imaging
Serum CA 19–9
Histopathological Confirmation
How do We Treat a Patient with Gallbladder Carcinoma?
Surgery for Gallbladder Cancer
Hepato-pancreato-duodenectomy (HPD)
Radical Lymph Node Dissection
Should an Extra-hepatic Bile Duct Excision (EHBDE) be Performed in all Patients?
Radical Re-resection
Should Gallbladder Cancer be Performed Laparoscopically?
Is Aggressive Surgery the Answer to Long-term Survival in Gallbladder Cancer?
What is the Role of Chemotherapy and Radiotherapy?
Other Palliative Strategies
Obstructive Jaundice
Peritoneal Disease and Ascites
Intestinal Obstruction (Gastro-duodenal/colonic)
CONCLUSION
10:
Evolution and Evaluation of Newer Prosthetic Material
INTRODUCTION
Ideal Prosthesis
Physiological Reconstruction
Comparison of Mesh Construction
Strength Requirements
Types of Prostheses
Polypropylene
Polyester
PTFE
Lightweight Composite Meshes without Adhesion Prevention “Barrier”
New Composite Meshes with adhesion prevention “Barrier”
Absorbable “Barrier” Composite Mesh:
Non absorbable “Barrier” Composite Mesh
Bard Composix Mesh
GORE-TEX Dual Mesh
Normal Peritoneal Healing: Mesothelialization
Comparison of Elasticity and Tensile Strength of Various Prostheses
Polyvinylidene Fluoride Mesh
Biological Mesh
Criteria for Mesh Selection
Fixation of Mesh
Complications
Future
SUMMARY
11:
Abdominal Wound Dehiscence: The Science and Art of its Occurence and Prevention
INTRODUCTION
Definition
Prevalence
Diagnosis
Anatomy of abdominal wall
1. Preoperative factors:
2. Operative factors: A sutured wound bursts because either the suture breaks or its knot slips or it cuts through the tissues.
Intra-abdominal Pressure (lAP)
Intra-abdominal Hypertension (IAH)
Abdominal Compartment Syndrome (ACS)
Complications of leaving the abdomen open
Prevention of burst abdomen
Management of Burst Abdomen
SUMMARY
12:
Pancreatic Resectional Surgery: What does Evidence Based Medicine Teach us Today?
INTRODUCTION
Pylorus Preserving PD (PPPD) Versus Classical Whipple (cW)
Pancreatic Anastomosis Pancreatico-jejunostomy (PJ) versus pancreatico-gastrostomy (PG)
Pancreatic Anastomosis Does stenting of main pancreatic duct influence outcome?
Delayed Gastric Emptying (DGE) after PD: Does the Type of Reconstruction Influence Outcomes?
Hemorrhage after PD: Re-surgery Versus Angiography
Management of Pancreatic Remnant after Distal Pancreatectomy. Is Stapler Closure Superior to Hand Sewn Closure?
Extended Lymphadenectomy and Radical Pancreatic Resections What are the indications?
Improved Result of Pancreatic Resections Are hospital volumes important?
Laparoscopic Pancreatic Resections What guidance does evidence provides today?
13:
Non-Variceal Upper Gasrointestinal Bleeding Current Concept in Management
INTRODUCTION
Common Causes of Nonvariceal Upper GI Bleeding (UGIB)
Epidemiology of Non-variceal UGIB
Clinical Presentation
Risk Predictors on Presentation
Diagnosis
Current Concepts in the Management of Non-variceal Upper GI Bleeding
Modified Forrest Classification of Ulcers
Therapy for Non-variceal Upper GI Bleeding
Endoscopic Therapy for Non-variceal Upper GI Bleeding
Role of Proton Pump Inhibitors (PPI)
Role of Helicobacter Pylori Eradication
Surgery for Nonvariceal Upper GI Bleeding
Surgery for Bleeding Peptic Ulcer
Bleeding Gastric Cancer
Dieulafoy's lesion
Mallory-Weiss Syndrome
Acute Hemorrhagic Gastritis
Hemosuccus Pancreaticus
Conclusion
14:
Gastrointestinal Stromal Tumors
INTRODUCTION
DEMOGRAPHY
Location
Clinical Presentation
Pathology
Immunology
Predictors of malignant potential
Investigations
Treatment
Molecular Targeted Therapy
Assessment of Response to Therapy
Resistance to imatinib
Sunitinib and other newer agents
Prognosis
15:
Prevention and Control of Injury: Role of the Surgeon
BACKGROUND
DEFINITIONS
THE BURDEN OF INJURY
MODERN CONCEPT OF INJURY PREVENTION
Haddon Matrix of Injury Etiology
Injury Prevention and Control and Trauma Care
Injury—A Public Health Problem
SCOPE OF INJURY PREVENTION
Road Traffic Injury
Burns
Drowning
Falls
Occupational Injury
Poisoning
Other Unintentional Injuries
Wrong-side, Wrong-site, Wrong-procedure and Wrong-patient Adverse Events (WSPEs)
Injuries due to Surgical Diathermy
Retained Foreign Bodies following Surgery
Violence
Suicide
Homicide
ROLE OF THE SURGEON IN INJURY PREVENTION
EDUATION REGARDING INJURY PREVENTION AND CONTROL
Education of Health Professionals
Patient education
16:
Improving the Outcome of Surgery: Application of six Sigma in Healthcare
REFERENCES
INDEX
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