Emergency General Surgery has become a cornerstone of Acute Care Surgery over the past decade. Once the scope of community general surgeons, the growing complexity of patients with acute surgical diseases has increasingly driven their care to tertiary referral centers. The aging population confounds this problem further as these patients present with more complex comorbidities, life-threatening physiology, and progressively severe anatomic disease severity. To ensure better outcomes, the practice has evolved to focus on evidence-based practice management guidelines in order to standardize care and optimize outcomes. The purpose of this text is to be a comprehensive volume for patients with acute surgical diseases. There will be three sections, each comprised of multiple chapters. The first section will be a comprehensive analysis of the background of Emergency General Surgery. The goal of this section will be to provide the reader background into the acute surgical practice and to introduce the reader to the important concepts discussed in the remainder of the textbook. The second section will be the largest and will discuss specific acute surgical diseases. Individual chapters will outline the diagnostic approach, current treatment standards, operative approaches, and expected outcomes with an emphasis on practice management guideline implementation into practice. As acute surgical diseases and surgical critical care are integral to each other, the last section will be Critical Care for the Acute Care Surgeon. These topics will focus on the critical care concepts essential to surgeons who care for acute diseases. This comprehensive text is targeted to any surgeon who takes emergency call for any of the listed diseases including community and referral general and vascular surgeons. In addition, this would be an excellent resource for all general surgery residents. Lastly, this would also serve as a resource to intensivists who care for acute surgical patients.

Chronic venous insufficiency, manifesting as disabling open leg ulcers, lipodermatosclerosis and severe cutaneous hyperpigmentation is thought to affect five percent of the population over age 80 and a significant proportion, probably greater than one percent, of Western populations under age 65. To date little has been known about how to treat this condition cost-effectively beyond supportive and palliative care. Thus, the most important feature of Chronic Venous Insufficiency is that it describes the interventions which markedly ameliorate, and in some cases cure, the condition. The authoritative text has been skilfully illustrated to show how new methods of endovascular and endoscopic interventions can be integrated with radiologic techniques to correct totally the abnormalities which produce chronic venous insufficiency. Taken as a whole this volume will enable general surgeons, vascular surgeons, dermatologists and interventional radiologists to treat a condition that was, until recently, thought to be untreatable.

It is a great pleasure and honor to be asked to participate in the translation of this important and historical volume on thoracic surgery and to provide this foreword. Martin Kirschner of Mannheim/Heidelberg was an early pioneer in thoracic and esophageal surgery. His operation for bypass of the esophagus using the entire stomach remains a standard of the surgical armamentarium to this date. The original Kirschner Textbook of Surgery was a standard in its day. We are fortunate that Professors H. Pichlmaier and F.W. Schildberg and other colleagues have provided us with this important modern successor of a classic textbook. The reader is rewarded by an extensive treatise which includes not only the most up to date techniques in pulmonary, esophageal, mediastinal, and chest wall (including breast) surgery but also provides an excellent perspective on the techniques used by pioneers in the field. Although some of these early techniques are not commonly used today, knowledge of their use and application broadens the capability of the thoracic surgeon. Changing times bring renewed problems with infectious diseases. Knowledge of the management of the pleural space and pulmonary infectious problems is a critical part of the education of the thoracic surgeon.

This comprehensive manual discusses the many aspects of inflammatory bowel disease (IBD), providing relevant information along with practical guidance. The reader is also directed to additional resources for extra and current information. This book comes at a time when the number of people suffering from the two major forms of IBD, ulcerative colitis (UC) and Crohn's disease (CD), is rising around the globe. Despite their huge impact on daily life and health economics, these diseases are not fully understood, and diagnosis and treatment remains a significant challenge. IBD nurses are increasingly recognised as key clinicians within the multidisciplinary team caring for people with IBD. Through experience and specialist knowledge IBD nurses provide timely support, advice, and treatment for people living with this unpredictable condition. IBD nurses are also well placed to liaise with the wider team, developing patient centred services which best fit their local health framework. The combined international expertise and accessible guidance here will equip nurses, or any clinician wanting to increase their competence in IBD management. Thereby this manual aims to contribute to the optimisation of IBD care throughout the world.

As any new field in medicine develops, an the history of transplantation and the current accompanying documentation occurs in a rea status of hemodialysis as it relates to trans sonable and logical sequence. Early in the de plantation. In addition, the areas of tissue his to velopmental life of clinical transplantation, compatability typing, patient evaluation, the many research articles and case reports were transplant operation, immunosuppressive drugs, presented in the literature, and shortly there and follow-up investigations are well and clearly after, a series of textbooks were published. documented, as are the medical complications These textbooks dealt primarily with the per and the psychiatric and social problems en sonal experiences of clinicians working in the countered in kidney transplantation. major centers, who were embarking in the new Although Dr. Chatterjee draws primarily on field, as were Dr. Starzl, Dr. CaIne, Dr. Sim his own experiences, he fairly presents all the mons, and myself. This field of investigation has issues in areas in which there is controversy or now become an accepted clinical discipline, and differences of opinion. Most major university thus it is highly desirable that a manual should medical centers now have a clinical renal trans be available for the residents and house staff plantation service, and I feel that this manual who will receive training in this important area. will be an invaluable tool for their house staff In this manual, Dr. Satya N. Chatterjee pre and students alike."

It is easy to make anecdotal claims for the efficacy of new forms of treatment based on the short term results in a small number of patients. Many authors have done this for endoscopic laser therapy in the gastrointestinal tract. It is very much more difficult to carry out a comprehensive assessment of the short and long term effects of new techniques and to compare these with the results of alternative treatments for the same diseases. This book, from one of the world's leading departments of gastroenterology, describes and analyses the largest series of patients yet reported from one centre treated endoscopically with the NdYAG laser for gastrointestinal disease. The follow up extends over 8 years and the results are impressive. Some of the early claims for laser therapy have been validated, others have not, but the real value of the book is that we now have a large amount of well organised data on which to judge the merits of laser therapy. Medical laser techniques are in their infancy and the potential for future develop ment is enormous, but ideas on current applications have been consolidated and that is essential before the next concepts evolve. This book has taught us how to walk. The world is now ready to learn to run S. G. Bown, Director National Medical Laser Centre London Contents INTRODUCTION 3 Introduction and purpose of the study 5 1 General aspects of laser 6 1. 1."

Peritoneal Surgery addresses the response of the peritoneum to injury and the prevention of post-surgical adhesions resulting from general and gynecologic surgery. Adhesions, or scar tissue binding two normally separate surfaces, form when the peritoneum, the membrane covering the abdominal wall and protecting the inner organs, is damaged during surgery, inflammation, or injury. Negative complications from adhesions include pelvic pain, infertility, intestinal obstruction, multiple surgical complications resulting from surgery to remove or pull them apart, and therefore a greater surgical workload and economic burden to the healthcare system. In this book, experts in the field address peritoneal repair, the role of surgical technique to prevent adhesions, adhesion formation, complications of adhesions, and developing technology in the prevention of adhesions.

In December, 1966, two patients dying of months after the transplants had been per uremia as a result of diabetic kidney disease formed. This was long enough, however, to were offered a small chance of survival. Ac establish unequivocally in both patients cording to the thinking of the time, it was that an endocrine organ, the pancreas, could inappropriate-and perhaps even unethical function normally and for many days as a to offer them either chronic hemodialysis or human-to-human graft. The patients had kidney transplantation. These were considered become normoglycemic independent of insulin a waste of effort because it was believed that injections. scarce medical resources should not be spent The possible long-term benefits of restoring on patients, uremic or not, whose chances of insulin function were hotly argued then, and surviving for more than a few months were they have not been fully determined 20 years thought to be very small. Reduced to its later. It seems to me now, however, that the essence, the idea was that diabetic patients basic premise is sounder than I realized in were terrible risks and would remain so even if 1966: if one could restore an effective, norm the uremia were corrected."

Molecular Genetics of Colorectal Neoplasia A Primer for the Clinician provides the latest information on the genetics of colorectal cancer within a context of basic genetics, describing the subject in understandable language and making it clinically relevant. In this way, clinicians can become familiar with genetic terms and techniques related to colorectal neoplasia, providing a background upon which to build an appreciation of future advances and an ability to include them in the practicalities of patient care. This edition is intended for the healthcare provider or industry concerned with colorectal neoplasia: including general and colorectal surgeons, pathologists, oncologists, gastroenterologists, internal medicine and family practice physicians, nurses, geneticists, counsellors, registry co-ordinators, epidemiologists, and statisticians.

Liver Cancer provides the general surgeon, surgical oncologist, and medical oncologist with the most current standard of multimodality care for hepatobiliary cancer. Surgical approaches, chemotherapy, immunotherapy, gene therapy, and radiotherapy are all presented.

Recent clinical trials of adjuvant therapy for gastric cancer in Japan have shown improved survival benefits, but the results have been considered controversial and have been viewed with some skepticism in the West. Until now, the efforts of Japanese surgical oncologists in multimodality therapy have not been fully understood because they have not been adequately reported in English. This volume now presents the experience and expertise of Japanese surgeons who utilize preoperative or intraoperative chemotherapy, or a combination of systemic and regional chemotherapy. Their collected work provides valuable insight in the Japanese perspective and success in treating gastric cancer. Included in the appendix is an extensive tabular analysis of the gastric cancer database at the Cancer Institute Hospital of Tokyo. Probably the largest such database in the world from a single institution, the analyses present the state of the art in treatment of gastric cancer.

Despite 50 years of antibiotics, infection remains a major source of both morbidity and mortality. Immunosuppression, either secondary to drugs in transplant recipients or secondary to HIV, has expanded the number of microorganisms that are known to be pathogenic in man. Imaging of infection has a vital role both in the initial diagnosis and in the continuing management of patients with infection or suspected infection. Functional imaging using nuclear medicine techniques has a unique role to play in identifying sites of infection in a wide range of patients with varying clinical conditions. This book, written by a series of experts not just in the fields of nuclear medicine but also infectious disease and radiology, discusses the role of nuclear medicine in three parts: a review of the pathophysiology of infection; a technical description of those nuclear medicine techniques which can be used in imaging infection; an extensive systematic review including thoracic, abdominal and orthopaedic infection as well as a special section on the acutely ill patient, the immunosuppressed patient and the patient with pyrexia of unknown origin. This book will be of interest to all clinicians looking after patients with infection and who need to use imaging techniques. It will also be of use to radiologists and nuclear medicine physicians who will be using these techniques clinically.

This is a user-friendly reference on all aspects of office-based anorectal surgery for general surgeons and surgeons in training. Well-illustrated, this practical manual shows step-by-step procedures for commonly performed anorectal procedures. The book includes ancillary considerations of ambulatory surgery with timely chapters on set-up of the facility, anesthetic considerations, selection of patients, pre-op and post-op management, nursing aspects, and coding and billing.

This book intends to provide a comprehensive and up-to-date description of the newest techniques in minimally invasive liver surgery. The treatment of liver diseases comprises a significant component of the practice of any general surgeon working either in the academic, general and community hospitals. With the rapid expansion of knowledge and technology also the liver has been approached laparoscopically in a few specialized centers with well recognized advantages for the patients. Now this large amount of experience will be made universally available through this book. After a concise description of the main tools and technology necessary to carry out a safe laparoscopic and/or robot-assisted liver surgery, details of operative techniques will be illustrated. Each chapter will consist of an introduction, a summary of the indications and contraindications of specific operative procedures and a detailed description of each surgical procedure, including the potential complications of both the surgery and the postoperative care. A special effort will be done to provide informative and accurate illustrations and pictures, that will be completed by the DVD containing the movies illustrating the technical procedures performed by the leading European liver surgeons.

As in any multiauthored textbook penned by When I was first approached by the publisher of this volume, Martinus Nijhoff, Boston, I writers of diverse backgrounds and interests, explored the possibility of writing a personal Modern Stereotactic Neurosurgery to some monograph on contemporary stereotactic extent suffers from incompleteness. Future surgery. After a review of available literature, volumes no doubt will include many additions several aspects became apparent. First, no cur from other authors who also are important rent, readily accessible, multiauthored text de specialists in the field. Because not all authors signed to survey the field was available. Those write in the same style (or even language), we books that were available tended to heavily have attempted to achieve a more cohesive text emphasize theory, physiology, and anatomy. in the editorial process. Each chapter has been Second, stereotactic surgeons were considered subdivided into pertinent headings for easier abstruse and for too long were relegated to a reference. Because of my own background, status outside of the mainstream of neuro some readers will note an Americanization (as surgery. This attitude probably reflected the opposed to anglicization) of the chapters. insufficient explanation of the practical uses While many chapters comprise primarily sum and advantages of stereotactic technique. maries of the authors' work within the field, Third, in recent years, the field has expanded each author was encouraged to review the liter so rapidly that it has become a major compo ature in that discipline if appropriate."

A workshop was organised in order to achieve multi-discipli- nary review of the pathogenesis and management of acute failure, particularly as it occurs and is managed in intensive therapy units. The book deals with the realities and practicalities of this important area of acute medicine. Each chapter is followed by a discussion, so that a concen- sus view is obtained from an international body of experts.

This manual is conceived as an aid to AO course participants both in grasping theoretical principles and in performing practical exercises, as well as a practical guide for clinicians in the application of AO principles. These principles are discussed in Part I and related to notions of stability, biomechanics, and technique. In addition to interfragmentary fixation and load bearing, the technique of external fixation is explained. The use of rigid external fixators with the mandible is proposed as a replacement for pin fixation, which has been obsolete for over two decades. Part II is a practical guide to the theoretical principles set forth in the first section of the volume, with the focus on case studies classified according to fracture type. This section provides a solid empirical basis of particular value in establishing indications and selecting appropriate techniques. Equally important is the anatomy of surgical points of access. In Part III, the increasing variety of indications for rigid internal fixation is confirmed. Three areas take on particular relevance here: the surgical treatment of pseudarthrosis, the by-pass of primary defects as an integral part of mandibular tumor surgery, and sagittal splinting and condylar replacement for orthopedic interventions involving the locomotor system of the mandible. A foldout entitled "AO Classification of Mandibular Fractures" is inserted at the back of the book. Its purpose is to help the clinician confronted by an acute case to determine its classification.

Uterine fibroids are the commonest benign tumors of the uterus and pelvis, and are the single most common cause of surgery in women apart from childbirth. Originally published in 2003, this pioneering book compares and contrasts conventional surgical treatments with the rapid emergence of uterine artery embolization as an alternative and less invasive procedure, and is of major importance in relation to the treatment of the condition. A host of international experts from gynecology and interventional radiology have contributed chapters, including one by Dr Jacques Ravina, the pioneer of uterine artery embolization. Although the main focus is on embolization, the book does also give a very comprehensive account of the epidemiology, pathology, diagnosis and management of uterine fibroids, and of conventional treatments such as hysterectomy and myomectomy. This all-inclusive approach makes the book suitable for gynecologists, radiologists, and for all trainees and residents looking after patients with uterine fibroids.

Flaps: Decision Making in Clinical Practice is an excellent readable guide for surgeons utilizing multiple techniques in plastic and reconstructive surgery. The authors have organized a pragmatic guide, specifically focused on those flaps which surgeons find difficult and challenging, with the latest technical developments in all anatomical areas.

Minimally invasive or laparoscopic surgery is becoming increasingly commonplace, as technology has enabled a minimally invasive approach to be offered as a feasible alternative to conventional open surgery for a number of important surgical procedures. This comprehensive, but concise and practically oriented introduction to the subject was first published in 2004 and will be of value to all anaesthetists with an interest in minimally invasive techniques. It begins by covering the key aspects of basic physiology, moves on to patient preparation and positioning, monitoring, the anaesthetic procedures themselves (including possible complications and contraindications and easy-to-follow 'how to' guides for a number of key procedures) and, finally, post-operative pain. Written by a leading expert in the field, from a well-known European centre of excellence, it is essential reading for anaesthetists and intensivists at all levels of expertise.

Barrett's Esophagus gives an extensive overview written by the world's leading experts covering the epidemiology, gastroenterology and surgery, as well as the molecular basis of:

• the precursor lesions leading to the development of Barrett's epithelium;
• the unique characteristics of Barrett's esophagus;
• the consequences of malignant degeneration, i.e. adenocarcinoma.

All aspects in terms of diagnosis, secondary prevention, multimodality, medical and surgical treatment are elucidated.

- Not only written by experts but the content of each of the chapters has also been peer-reviewed.

- Presents a step-by-step approach to the treatment of chronic wounds.

- For dermatologists, but also many other medical disciplines such as general practitioners and family physicians who also treat chronic wounds.