Comprehensive Textbook of Surgery Dinesh Vyas, Nav Yash Gupta, Vijay Mittal, Sanjeev V Chhangani, Tarun Kumar, Rahul Kalla
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1Comprehensive Textbook of SURGERY
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3Comprehensive Textbook of SURGERY
Editor-in-Chief Dinesh VyasMD MS FICS Assistant Professor, Department of Surgery Director, MS Surgery Clerkship Adjunct Professor, Institute of International Health Nanotechnology Biomedical Lab College of Human Medicine, Michigan State University Lansing, MI, USA Nav Yash GuptaMD FACS Chief, Division of Vascular Surgery North Shore University Health System Skokie, IL, USA Vijay MittalMD FICS FACS Clinical Professor Wayne State University School of Medicine Detroit, MI, USA Associate Editors Sanjeev V ChhanganiMBA MD FCCM Intensivist, Massachusetts General Hospital Harvard Medical School Boston, MA, USA Tarun KumarMD MCh FICS Assistant Professor Department of Pediatrics Surgery St Louis University, St Louis, MO, USA Rahul KallaMBBCh MD MRCP Small Bowel Disease Unit Division of Gastroenterology Sheffield University, Sheffield, UK Foreword Craig Coopersmith
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Comprehensive Textbook of Surgery
First Edition: 2012
9789350250525
Printed at
5Dedicated to
My brother Mahesh Vyas, Orthopedics Surgeon and My father Purshottam Das Vyas Scientist, Educationist and Social Worker They both have influenced me to pursue medicine for the most needed
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7CONTRIBUTORS 9FOREWORD
I am honored to have been asked to write the foreword for this exciting new textbook entitled Comprehensive Textbook of Surgery, edited by Dr Vyas, Dr Gupta, Dr Mittal, Dr Changgani, Dr Kumar and Dr Kalla. Surgery is an intensely personal endeavor. The bond between surgeon and patient is one of the most intimate known to humanity. A patient trusts a surgeon enough to literally put him into a chemical-induced coma, go inside his body, remove or rearrange vital organs, and stitch them back together, in the hopes of a better future than when he went to sleep. In turn, a surgeon takes expertise obtained from years or decades of training and experience and makes a promise to a patient—“no matter what, I will take care of you.”
Increasingly, surgery is also a global endeavor. It is common for surgeons to train and practice in many cities and frequently many countries. In the goal of pursuing what is best for their patients, surgeons will travel far and wide to obtain the requisite skills needed to ensure a positive outcome.
The book sits at the crossroads between the personal and global nature of surgery. The distinguished international editorial board and authors have been carefully assembled to give a view of surgical fundamentals and advanced practice that is not possible in a single city, institution or even country. The lessons taught are universal and are valuable to surgeons everywhere. Each reader of the book is a student of the art of surgery in some way—from a junior medical student on their first rotation to the department, chair in-charge of a major national organization. Each will find something to learn here.
In many ways, the editor-in-chief of this book personifies the lofty goals of the book. Dr Dinesh Vyas' surgical journey began in India, and has found its way through England, France, and the United States, where I was fortunate to work to have him work in my laboratory studying surgical critical care. He brings a perspective that is at once global and at the same time, highly personal. This has led to a book that I believe will be instructive from the most rural communities with a single general surgeon to the most highly specialized academic centers.
I offer my most sincere congratulations to the editors and contributors for putting together this enlightening and comprehensive book.
Craig Coopersmith md facs
Professor of Surgery
Director, Surgical ICU
Emory University
Atlanta, USA10
11PREFACE
I have brought together contributors, who are experts in their respective fields and are recognized as such. In this process, the editors and contributors remained cognizant of the practical limitations and variances of treating the most general surgical conditions in South-East Asia. This book is a comprehensive review of general surgery that is clinically oriented with a multitude of practical pearls as well as numerous illustrations and charts that summarize information. The main focus of the book is medical and operative management of general surgical conditions. However, there is abundant coverage of medical management and nonoperative treatment of various disease processes.
Comprehensive Textbook of Surgery has been written keeping in mind the disconnect between currently available surgery textbooks and the resources available in the most hospitals in the world. The target audience is medical students, nursing students, surgery residents and surgeons. With simple, easy-to-understand language, it is meant to be an easily accessible resource for surgeons regarding practical advice on the best care available at the present time. A group of six distinguished and accomplished editors with more than thirty contributors have made contributions regarding basic and new surgical diseases, options for diagnosis and treatment of disease processes with the resources avialable to you, the pros and cons of various treatment options, and the management of complications. Emphasis is on common surgical related issues in critical care with chapters on cardiology, renal and infectious diseases. There is an introduction to use of radiology in your practice and a thrust towards lesser invasive interventions with readily available ultrasound machines.
Comprehensive Textbook of Surgery emphasizes trauma management and care. As a surgeon, I have a huge responsibility towards ensuring timely and appropriate care of trauma patients with a systematic approach. The potential for improvement in the care of trauma patients is significant. A textbook such as this is well overdue and will be a refreshing addition to the current cadre of textbooks in this arena.
Dinesh Vyas12
13ACKNOWLEDGMENTS
The book has been a brainchild of last 20 years of experience of practicing surgery in various parts of the world and understanding disconnect between the practice, resources and textbooks. There are areas of patient care that have huge need for relevant education and then there are areas of simplification of the textbook.
Surgeons like any physician are overwhelmed with information and at every stage it is important for them to understand and prioritize their reading. In surgery, there are multiple textbooks that have served to some extent all surgeons, but again they leave a lot of areas of question, as the surgeons have lack of global exposure.
I am fortunate to have surgeons from all parts of globe contributing in this text and all are active in their surgical practice at the best institutes of the world.
I wholeheartedly appreciate the efforts of all the editors and contributors of the textbook. There are many others in the publishing that have enabled me to successfully complete this mission. Professor Nav Yash Gupta and Professor Vijay Mittal have been constant support, inspiration and guide in my mission and helped with contributions and editing. I am thankful to the editorial staff and management especially Mr Tarun Duneja (Director-Publishing) and Mr KK Raman (Production Manager), M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India were extremely helpful with their support and assistance throughout the project.
Lastly, I acknowledge the everlasting strength, support, and vision of my life, Arpita, my mother, Shyama and my daughter, Anoushka for their patience, nurturing personal environment to enable me to complete this vision.
This work is just a start and I have more work in my hand and I think the current team made me more determined to take challenging task and complete them with ease in future.14