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Recent Advances in Surgery 35
Colin D Johnson, Irving Taylor
SECTION 1: SURGERY-IN-GENERAL
1:
Perioperative Care
INTRODUCTION
PREOPERATIVE ASSESSMENT
IDENTIFYING RISK
DETECTING DISEASE
JEHOVAH’S WITNESSES
OBESITY
DIABETES MELLITUS
PERIOPERATIVE MANAGEMENT OF MEDICATION
ANTITHROMBOTIC THERAPY
SAFE SURGERY
PREOPERATIVE FASTING
PERIOPERATIVE FLUID REPLACEMENT
PATIENT POSITIONING
SUMMARY
2:
Biologic and Composite Mesh for Repair
BIOLOGIC MESH
Structural Properties
Clinical Use
Allografts
Alloderm
Porcine Xenografts
Surgisis
Permacol
Strattice
Collamend
Bovine Xenografts
Tutopatch
Tutomesh
Veritas
Parastomal Hernia Repair
COMPOSITE MESH
CONCLUSION
3:
Perioperative Cardiopulmonary Exercise Testing for Major Abdominal Surgery
INTRODUCTION
CARDIOPULMONARY EXERCISE TESTING
Conduct of a Cardiopulmonary Exercise Testing
Cardiopulmonary Exercise Testing-Derived Variables
Current Applications and Evidence-Based Value of Cardiopulmonary Exercise Testing
Major Intra-Abdominal Surgery
Vascular Surgery
Upper Gastrointestinal and Bariatric Surgery
Transplantation
DISCUSSION
SECTION 2: BREAST SURGERY
4:
Breast Reconstruction: How do we Measure and Define Patient's Quality of Life and Satisfaction?
INTRODUCTION
TYPES OF RECONSTRUCTION
WHAT DO WE MEAN BY ‘PATIENT SATISFACTION?’ PATIENT REPORTED OUTCOME MEASURES
Measuring Patient Reported Outcome Measures
BREAST-Q
MANAGING EXPECTATIONS
DECISION MAKING: ‘NOTHING ABOUT ME WITHOUT ME’
KEY FINDINGS OF THE NMBRA FOURTH REPORT
ADJUVANT TREATMENTS AND EFFECTS ON HRQL AFTER BREAST RECONSTRUCTION
CONCLUSIONS
ACKNOWLEDGEMENTS
5:
Surgery for Benign Breast Conditions
INTRODUCTION
GYNAECOMASTIA
Investigations
Management of Gynaecomastia
MASTALGIA
Management of Mastalgia
NIPPLE DISCHARGE
Investigations
Management of Nipple Discharge
BREAST SEPSIS
Management of Breast Sepsis
Management of Lactational Abscess
Management of Non-Lactational Abscess
PERCUTANEOUS MANAGEMENT OF BENIGN BREAST LESIONS
Large Core Vacuum-Assisted Breast Biopsy and Excision Systems
Vacuum-Assisted Mammotomy Systems
Single Large-Core Biopsy System
Radiological Excision of Fibroadenomas
Radiological Excision of Papillomas
Radiological Excision of Radial Scars
CONCLUSION
SECTION 3: FACIAL SURGERY
6:
Management of Facial Paralysis
INTRODUCTION
NEURAL TECHNIQUES
Primary Neurorrhaphy
Interpositional Grafts
Cranial Nerve Crossover
REGIONAL MUSCLE TRANSPOSITION
FREE MUSCLE TRANSFER
OPHTHALMIC PROTECTION AND REHABILITATION
Conservative Orbital Protection
Botulinum Toxin
Corneal Protective Surgery
ADJUNCTIVE TECHNIQUES
THE FUTURE
CONCLUSION
SECTION 4: GASTROINTESTINAL SURGERY
7:
Managing the Complications of Bariatric Surgery
INTRODUCTION
RISK, RISK REDUCTION AND IMPROVING OUTCOMES
COMPLICATIONS OF GASTRIC BANDING
Early
Dysphagia
Port Infection
Late
Band Slip
Symmetric Pouch Dilatation
Megaoesophagus
Band Erosion
Port and Tubing Problems
COMPLICATIONS OF ROUX-EN-Y GASTRIC BYPASS
Early
Anastomotic Leak
Staple Line Bleeding
Late
Obstruction
Anastomotic Stricture
Marginal Ulcers
COMPLICATIONS OF SLEEVE GASTRECTOMY
Early
Staple Line Leak and Bleeding
Late
Reflux
Stricture
NUTRITIONAL CONSEQUENCES OF BARIATRIC SURGERY
THROMBOEMBOLIC COMPLICATIONS
GALLSTONES/BILE DUCT STONES
SUMMARY
8:
Metastases from Colorectal Cancer
DEFINING RESECTABILITY IN COLORECTAL LIVER METASTASES
THE IMPORTANCE OF SPECIALIST MULTIDISCIPLINARY TEAM INPUT IN THE MANAGEMENT OF METASTATIC COLORECTAL CANCER
STAGING AND SELECTION OF PATIENTS FOR LIVER SURGERY
TECHNICAL DEVELOPMENTS IN LIVER SURGERY
ABLATIVE THERAPIES FOR COLORECTAL LIVER METASTASES
CHEMOTHERAPY FOR METASTATIC COLORECTAL CANCER
Conversion/Induction Chemotherapy
Perioperative Chemotherapy
Chemotherapy-Associated Hepatotoxicity
Liver-Targeted Therapies
CONCLUSIONS
9:
Ischaemic Bowel
DEFINITION
MESENTERIC VASCULATURE
AETIOLOGY OF INTESTINAL ISCHAEMIA
ACUTE SUPERIOR MESENTERIC ISCHAEMIA
Epidemiology
Pathogenesis and Associations (Table 9.2)
Superior Mesenteric Artery Embolism
Superior Mesenteric Artery Thrombosis
Non-Occlusive Mesenteric Ischaemia
Superior Mesenteric Vein Thrombosis
Clinical Presentation
Differential Diagnosis
Investigations
Blood Tests
Plain Radiology
Duplex Scanning of Mesenteric Vessels
Computed Tomography Angiography
Mesenteric Angiography
Magnetic Resonance Angiography
Diagnostic Laparoscopy
Treatment: General Measures
Treatment: Specific Measures
Medical and Endovascular Treatments
Surgery
Outcome
CHRONIC SUPERIOR MESENTERIC ISCHAEMIA
Epidemiology
Pathogenesis and Associations
Clinical Presentation
Investigations
Duplex Ultrasonography
Mesenteric Angiography
Computed Tomography Angiography
Magnetic Resonance Angiography
Diagnosis
Treatment
Outcome
CONCLUSIONS
10:
Anal Cancer
INTRODUCTION
EPIDEMIOLOGY
RISK FACTORS
SCREENING AND VACCINATION FOR ANAL CANCER
PATHOLOGY
CLINICAL FEATURES
INVESTIGATION AND STAGING FOR SUSPECTED ANAL INTRAEPITHELIAL NEOPLASIA AND ANAL CANCER
Anal Intraepithelial Neoplasia
Anal Cancer
TREATMENT
Treatment of Anal Intraepithelial Neoplasia
Treatment of Squamous Cell Carcinoma of the Anal Margin
Treatment of Squamous Cell Carcinoma of the Anal Canal
Management of Inguinal Nodes
Treatment of Recurrent Disease
Treatment of Uncommon Anal Tumours
11:
Intraoperative Radiotherapy in the Management of Locally Advanced and Recurrent Rectal Cancer
BACKGROUND
RATIONALE
TECHNIQUES
ONCOLOGICAL OUTCOMES
Locally Advanced Rectal Cancer
Locally Recurrent Rectal Cancer
SUMMARY AND FUTURE DIRECTIONS
12:
Modern Management of Abdominal Tuberculosis
INTRODUCTION
MICROBIOLOGY
PATHOGENESIS
IMMUNOLOGY
PATHOLOGY
CLINICAL FEATURES
UNUSUAL SITES
ACUTE PRESENTATION
DIFFERENTIAL DIAGNOSIS
INVESTIGATIONS
COINFECTION WITH HIV
COEXISTENCE WITH CANCER
ANTITUBERCULAR THERAPY
SURGERY
OUTCOME
SECTION 5: VASCULAR SURGERY
13:
Management of the Diabetic Foot
INTRODUCTION
EPIDEMIOLOGY
PATHOGENESIS
CLINICAL PRESENTATION AND EXAMINATION
DIAGNOSTIC INVESTIGATIONS
Vascular Investigations
Soft Tissue Infection and Osteomyelitis
TREATMENT OF THE DIABETIC FOOT
Medical Management
Infection Control
Revascularisation Options
Amputation Versus Limb Salvage
Multidisciplinary Team Approach
14:
Randomised Clinical Trials and Meta-analyses in Surgery
GENERAL
Appendicitis
Hernias
Wound Closure
OESOPHAGOGASTRIC
Bariatric
Gastro-Oesophageal Reflux Disease
Oesophagogastric Malignancy
Adenocarcinoma
Squamous Cell Carcinoma
Postoperative Management
HEPATOPANCREATOBILIARY
Liver
Pancreatic
Biliary
COLORECTAL
Colonoscopy/Bowel Imaging
Colorectal Cancer
Pelvic Floor Disorders
BREAST AND ENDOCRINE
Benign Breast Disease
Breast Cancer
INDEX
TOC
Index
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