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Roshan Lall Gupta’s: Recent Advances in Surgery (Volume 14)
Puneet
CHAPTER 1:
Molecular Markers of Thyroid Cancer
INTRODUCTION
MOLECULAR BIOLOGY OF THYROID CANCER
SPECIFIC MOLECULAR MECHANISM INCLUDING THE SILENCING OF THYROID-SPECIFIC GENES
MAP Kinase Signaling Pathway
PI3K Signaling Pathway
Aberrant Gene Methylation in Thyroid Cancer
Genetic Markers
Immunocytochemical Markers
Epigenetic Markers
APPLICATIONS OF MOLECULAR MARKERS
Diagnosis
Targeted Therapy
SURVEILLANCE
PROGNOSIS OF THYROID CANCERS
CHAPTER 2:
Carcinoma Male Breast
INTRODUCTION
EPIDEMIOLOGY
RISK FACTORS
GENETIC FACTORS
CLINICAL FEATURES
DIAGNOSIS
PATHOLOGY
IMMUNOHISTOCHEMISTRY/BIOLOGICAL CHARACTERISTICS
TREATMENT
Local Therapy
Radiation Therapy
Systemic Therapy
PROGNOSIS AND SURVIVAL
CONCLUSION
CHAPTER 3:
Mesenteric Ischemia
INTRODUCTION
Mesenteric Circulation
ACUTE MESENTERIC ISCHEMIA
Etiopathology
Clinical Presentation
Investigation
Treatment
Initial Resuscitation and Preoperative Preparation
Open Surgical Treatment
SMA Exposure
SMA Embolectomy, Endarterectomy with Patchplasty or Bypass
Endovascular Treatment in AMI
Hybrid Approach for AMI
Outcomes
NON OCCLUSIVE ACUTE MESENTERIC ISCHEMIA (NOAMI)
AMI in Aortic Dissection
AMI in Visceral Dissection
COLONIC ISCHEMIA POST INFRARENAL AORTIC INTERVENTIONS
CHRONIC MESENTERIC ISCHEMIA
Etiology and Pathophysiology of CMI
Clinical Presentation
Imaging
Revascularization in Chronic Mesenteric Ischemia
Open Surgical Treatment
Antegrade Celiac/SMA Bypass
Retrograde SMA Bypass
Transaortic Mesenteric Endarterectomy
Endovascular Treatment
Technique
Primary Angioplasty or Primary Stenting
Choice of Stents
Celiac Trunk Stenting
Retrograde SMA Stenting: Hybrid Approach
Outcomes: Open versus Endovascular Interventions
CONCLUSION
CHAPTER 4:
Endoscopic Ultrasound: Diagnostic and Therapeutic Role
INTRODUCTION
ENDOSCOPIC ULTRASOUND: THE INSTRUMENTS
DIAGNOSTIC ROLE OF ENDOSCOPIC ULTRASOUND
Endoscopic Ultrasound and Esophagus
Endoscopic Ultrasound: Role in Biliary Tract
Unexplained Biliary Ductal Dilatation
Common Bile Duct Stones
Biliary Strictures
Endoscopic Ultrasound: Role in Pancreatic Disorders
Endoscopic Ultrasound and Acute Pancreatitis
Chronic Pancreatitis
PREOPERATIVE STAGING OF GASTROINTESTINAL MALIGNANCIES
Endoscopic Ultrasound and Gastrointestinal Cancers
Endoscopic Ultrasound and Esophageal Cancer
Gastric Cancer
Rectal Cancer
Pancreatic Cancer
Endoscopic Ultrasound and Pancreatic Cystic Neoplasm
Endoscopic Ultrasound and Lymphoma
Endoscopic Ultrasound in Submucosal Lesions
Endoscopic Ultrasound and Tuberculosis
Miscellaneous Diagnostic Roles
ADVANCES IN DIAGNOSTIC ENDOSCOPIC ULTRASOUND
Contrast-enhanced Endoscopic Ultrasound
Endoscopic Ultrasound Elastography
Therapeutic Role of EUS
Drainage of Pancreatic Fluid Collections
EUS-guided Biliary Drainage
EUS-guided Celiac Plexus Blockade/Celiac Plexus Neurolysis
Oncological Interventions Under EUS Guidance
Endoscopic Ultrasound in Portal Hypertension
Miscellaneous Therapeutic Roles
CONCLUSION
CHAPTER 5:
Liver Resection: Indication, Planning and Complications
INTRODUCTION
SEGMENTAL ANATOMY OF THE LIVER
INDICATIONS FOR LIVER RESECTION
MALIGNANT LIVER TUMORS
Primary Malignancies
Hepatocellular Carcinoma
Cholangiocarcinoma
Secondary Malignancies
Colorectal Cancer Metastases
Non-colorectal Liver Metastases
Neuroendocrine Metastases
Other Non-colorectal Metastases
PREMALIGNANT LIVER TUMORS
Liver Cell Adenomas
BENIGN LIVER TUMORS
Hemangioma
Focal Nodular Hyperplasia
PREOPERATIVE WORKUP
Radiological Workup
PLANNING OF LIVER RESECTION
Assessment for Feasibility of Liver Resection
CT and MRI Volumetry
Liver Function Tests and Objective Scoring Systems
LiMAx
Galactosyl Human Serum Albumin Scintigraphy
Indocyanine Green Clearance Test
OPTIONS IN PATIENTS WITH INADEQUATE FUTURE REMNANT LIVER VOLUME
TYPE OF LIVER RESECTION AND OTHER CONSIDERATIONS
Lesion Size and Number
Location and Relationship to Major Vascular/Biliary Structures
Significance of Anatomical Variations
Portal Hypertension
Liver Parenchyma
Specific Considerations
CONTRAINDICATIONS FOR LIVER RESECTION
Relative Contraindications
Absolute Contraindications
PATIENT FITNESS
LIVER SURGERY
Types of Liver Resection
Options for Parenchymal Transection
Role of Vascular Occlusion during Liver Resection
Role of Low Central Venous Pressure Anesthesia
Laparoscopic versus Open Liver Resection
POSTOPERATIVE COURSE
Enhanced Recovery after Surgery
Complications of Liver Resection
Bile Leak
Ascites
Post-hepatectomy Liver Failure
CONCLUSION
CHAPTER 6:
Prognostic Factors in Colorectal Cancer
INTRODUCTION
STAGE OF THE DISEASE
Pathological Factors: Stage of Disease
N-Nodal Status
Total Number of Lymph Nodes
Sentinel Lymph Node Biopsy
Microscopic Nodal Metastases
Mesenteric Nodules
Distant Metastases
Liver Metastasis
OTHER PATHOLOGICAL PROGNOSTIC FACTORS
Serum CEA
Lymphovascular Invasion
Residual Tumor
Circumferential (Radial) Margin (CRM)
Tumor Grade
Histologic Type
Tumor Regression following Neoadjuvant Therapy: Tumor Regression Grading
Tumor Border
Proliferative Activity
Microvessel Density
CLINICAL PRESENTATION AND PROGNOSIS
GENETIC FACTORS AND PROGNOSIS
Microsatellite Instability
Loss of Heterozygosity of 18q
BRAF/MSI Status
Gene Expression Profiling
ColoPrint
Oncotype DX
ColDx
ColoGuideEx
ColoGuidePro
CONCLUSION
CHAPTER 7:
Oncoplastic Breast Surgery
INTRODUCTION
Consensus Statement of the International Panel
PATIENT SELECTION AND ASSESSMENT
TUMOR EXCISION
ONCOPLASTIC TECHNIQUES
Volume-Displacement Techniques
Level I OPBS Technique
Level II OPBS Techniques (Table 7.2)
Volume-Replacement Techniques
COMPLICATIONS OF ONCOPLASTIC BREAST SURGERY
ADVANTAGES AND DISADVANTAGES OF ONCOPLASTIC BREAST SURGERY
RADIOTHERAPY AND ONCOPLASTIC BREAST SURGERY
FOLLOW-UP
ACKNOWLEDGMENT
CHAPTER 8:
Carcinoma Gallbladder: An Incidental Finding
INTRODUCTION
PREOPERATIVE DIAGNOSIS
Incidental Finding during Cholecystectomy
Incidental Finding on Pathology
REASSESSMENT FOR STAGING AND RESECTABILITY
TIMING OF REVISIONAL SURGERY
REVISIONAL SURGERY
Extend of Liver Resection
Extend of Lymphadenectomy
Bile Duct Excision
Port Site Excision
Management According to Depth Invasion with Contraindication of Radical Procedure
PROGNOSIS OF INCIDENTAL DIAGNOSED CARCINOMA GALLBLADDER
ADJUVANT THERAPY
CONCLUSION
CHAPTER 9:
Molecular Imaging in Oncology
INTRODUCTION
DIAGNOSTIC MOLECULAR IMAGING
Positron Emission Tomography
Use of PET-CT in Diagnosis of Cancer
Use of PET-CT in Treatment Guidance
Evaluation of Treatment Response by PET-CT
Follow-up Patients with PET-CT
Limitations of FDG PET-CT
Measuring Additional Metabolic Processes with PET
DNA Synthesis with Nucleoside PET
Membrane Biosynthesis
Hypoxia with [18F]-Fluoromisonidazole PET
Oxygen Metabolism and Blood Flow
Receptor Binding
MOLECULAR IMAGING APPLICATIONS FOR CT AND US
MOLECULAR IMAGING APPLICATIONS FOR MRI
INTRAOPERATIVE MOLECULAR IMAGING
Identification/Visualization of Tumor Extent
Fluorescence Molecular Imaging
CLINICAL APPLICATIONS
Indocyanine Green
Tumor-Specific Agents
Preclinical Studies with Potential of Clinical Translation
Identification of Vital Structures
CONCLUSION
CHAPTER 10:
Varicose Vein
INTRODUCTION
CLINICAL EVALUATION
DIAGNOSTIC EVALUATION
Hand Held Doppler
Duplex Doppler Ultrasonography
VENOGRAPHY
Ambulatory Venous Pressure Measurement
PLETHYSMOGRAPHY
LEVEL OF INVESTIGATION
TREATMENT MODALITIES
NONOPERATIVE MEASURES
Inelastic Compression Therapy
Elastic Compression Therapy
INTERMITTENT PNEUMATIC COMPRESSION
LEG ELEVATION
MEDICAL AGENTS
Micronized Purified Flavonoid Fraction
Calcium Dobesilate
Pentoxifylline
Aspirin
Treatment of Superficial Venous Incompetence
Open Surgery for Superficial Venous Incompetence
Conservative Hemodynamic Correction of Venous Insufficiency
Minimal Invasive Techniques
Sclerotherapy for Superficial Venous Incompetence
ENDOVENOUS THERMAL ABLATION
Laser Ablation
Radiofrequency Ablation
Steam Vein Sclerosis
Glue Ablation
Mechanochemical Ablation
Outcome after Various Minimally Invasive Procedures
Treatment for Deep Venous Incompetence
VALVULOPLASTY
Treatment for Perforator Incompetence
Open Surgery
Subfascial Endoscopic Perforator Vein Surgery (SEPS)
RECURRENT VARICOSE VEINS
Varicose Veins in Pregnancy
CONCLUSION
CHAPTER 11:
Open Abdomen, Indications, Management and Definitive Closure
INTRODUCTION
PATHOPHYSIOLOGY OF IAH AND ACS
Intra-abdominal Hypertension
Abdominal Compartment Syndrome
BLADDER PRESSURE MONITORING
Fluid Resuscitation
Indications for Open Abdomen
Definitive Abdominal Closure (When and How?)
CHAPTER 12:
Bariatric Surgery: Current Concepts
INTRODUCTION
BARIATRIC SURGERY: INDICATIONS
Upcoming Indications Regarding Bariatric Surgery
Bariatric Surgery and Type 2 Diabetes Mellitus
Bariatric Surgery in Class I Obesity
Bariatric Surgery and Age
Bariatric Surgery in Children or Adolescents
Bariatric Surgery in Those Aged above 60 Years
CONTRAINDICATIONS OF BARIATRIC SURGERY
TYPES OF BARIATRIC SURGERY: CURRENT PERSPECTIVE
Biliopancreatic Diversion (BPD) ± Duodenal Switch (BPD-DS)
Adjustable Gastric Banding
Laparoscopic Sleeve Gastrectomy
Roux-en-Y Gastric Bypass
Upcoming Bariatric Procedures
Omega-loop Gastric Bypass (Single Anastomosis Gastric Bypass or Minigastric Bypass)
IMPACT OF BARIATRIC SURGERY ON OBESITY-RELATED COMORBIDITIES
Diabetes Mellitus
Metabolic Syndrome
Obstructive Sleep Apnea
Liver Disease
Reflux Disease
Others
COMPLICATIONS OF BARIATRIC SURGERY
FUTURE DIRECTIONS
CONCLUSION
CHAPTER 13:
What's New in the Treatment of Diabetic Foot Ulcers?
INTRODUCTION
BIOENGINEERED SKIN AND TISSUE EQUIVALENTS
Human Fibroblast Derived Dermal Substitute
Allogeneic Bilayered Cultured Skin Equivalent
Negative Pressure Wound Therapy
Hyperbaric Oxygen Therapy
ELECTRICAL STIMULATION
ULTRASOUND THERAPY
LOW-LEVEL LASER THERAPY
GROWTH FACTORS
STEM CELLS IN DIABETIC FOOT ULCERS
CONCLUSION
CHAPTER 14:
Fistula-in-Ano
INTRODUCTION
ETIOLOGY
PRESENTATION
ASSESSMENT AND INVESTIGATION
Fistulography
Endoanal or Endorectal Ultrasonography
Magnetic Resonance Imaging
Computed Tomography
TREATMENT OF FISTULA-IN-ANO
Indications
Surgical Principle and Surgical Options
Seton
Fistulotomy
Mucosal Advancement Flap
LIFT Procedure
Video-assisted Anal Fistula Treatment
Fistula Plug
Fibrin Glue
Laser Therapy
Autologous Adipose-derived Stem Cell
AMERICAN SOCIETY OF COLON AND RECTAL SURGEONS PRACTICE PARAMETER
Simple Fistula-in-Ano
Complex Fistula-in-Ano
CONCLUSION
ACKNOWLEDGMENT
CHAPTER 15:
Total Parenteral Nutrition
INTRODUCTION
INDICATIONS FOR TOTAL PARENTERAL NUTRITION
NICE PATHWAYS
METHODS
COMPLICATIONS OF PARENTERAL NUTRITION (FLOWCHART 15.2)
Refeeding Syndrome
Long-term Total Parenteral Nutrition
Advantages of Enteral Nutrition over Parenteral Nutrition
USE OF ENTERAL NUTRITION VERSUS PARENTERAL NUTRITION
Early versus Delayed Supplemental Parenteral Nutrition
Prescriptions
Calculating Parenteral Feed
Physician Order
Parenteral Nutrition: Adult Form
Central Three-in-One
Others
NUTRITIONAL PRESCRIPTION: USE OF INDIRECT CALORIMETRY VERSUS PREDICTIVE EQUATIONS
Competencies
Monitoring of Feeding Regimens
Monitoring
Nutrition in Adult Patients with Renal Insufficiency
Europian Society for Parenteral and Enteral Nutrition (ESPEN) Guidelines on Parenteral Nutrition: Intensive Care
ESPEN Guidelines on Parenteral Nutrition: Surgery
Nutrition in Acute Phase of Critical Illness
Insulin Requirements in Critically Ill Patients
Nutrition in Mechanically Ventilated Patients
Albumin
Novel Substrates
CONCLUSION
INDEX
TOC
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