Advances in Surgery 2014
Advances in Surgery 2014
1st Edition
Published on 7. April 2015
100 pages
978-0-323-26464-8 (ISBN)
Description
Each year, Advances in Surgery brings you the best current thinking from the preeminent practitioners in your field. A distinguished editorial board identifies current areas of major progress and controversy and invites specialists to contribute original articles on these topics. These insightful overviews bring concepts to a clinical level and explore their everyday impact on patient care.
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Content
- Front Cover
- Advances In Surgery
- Copyright
- Contributors
- Contents
- Follow or Repair?
- Introduction
- Incidence
- Cause and natural history
- Clinical presentation and diagnosis
- Economic impact
- Management
- Women
- Men
- Symptomatic inguinal hernias
- Asymptomatic/Minimally symptomatic inguinal hernias
- The North American trial
- UK trial
- Long-term results of the randomized controlled trials
- The North American hernia trial
- UK trial
- Comparison between the 2 trials and their long-term follow-up studies
- Summary
- References
- Is It Safe to Follow Side Branch IPMNs?
- Introduction
- Epidemiology
- Diagnosis of Bd-IPMN
- Transabdominal ultrasonography
- Contrast-enhanced CT scan
- MRI with MR cholangiopancreatography
- Endoscopic US with cystic fluid analysis and cytology
- Management of Bd-IPMN
- Validation of the international guidelines for the management of Bd-IPMN
- Summary
- References
- Endoscopic Myotomy for Achalasia
- Background
- Technique
- Efficacy
- POEM in the setting of prior achalasia treatments
- End-stage achalasia
- Achalasia subtypes
- Extended indications: nonachalasia neuromotor disorders
- Gastroesophageal reflux disease
- Comparison with Heller myotomy
- Summary
- References
- Can Interventionalists do Endovascular Aortic Aneurysm Repair As Well As Vascular Surgeons?
- Background
- Who should perform EVAR?
- Centers of excellence for AAA management and EVAR
- EVAR skills of surgeons and interventionalists
- Is there a role for multidisciplinary EVAR care?
- References
- Does Walking Speed Predict Postoperative Morbidity?
- Introduction
- Importance of preoperative risk assessment for the older adult
- History of preoperative risk assessment
- Preoperative assessment: frailty
- Walking speed alone reflects multidimensional frailty
- Slow walking speed predicts adverse health outcomes
- Walking speed predicts adverse surgical outcomes
- Practical ways to measure walking speed
- Future directions
- References
- Does Close Temperature Regulation Affect Surgical Site Infection Rates?
- Introduction
- Pathophysiology principles
- Increased total oxygen consumption and decreased peripheral perfusion
- Induced coagulopathy
- Reduced immune response
- Principles applied to surgical practice
- Evidence base of clinical practice
- Summary
- References
- The Utility of the Robot in Pancreatic Resections
- Introduction
- Distal pancreatectomy
- Outcomes
- Reduced conversion rate
- Improved ability to perform splenic preservation
- Reduction in EBL
- Oncologic outcomes
- Cost
- Specific steps where the robot offers technical improvement in distal pancreatectomy
- Division of the pancreatic neck
- Vascular dissection
- Lymphadenectomy
- RDP
- Outcomes
- Operative times
- Open conversion and blood loss
- Morbidity
- Pancreatic Fistula
- Specific steps where the robot offers technical improvement in minimally invasive pancreaticoduodenectomy
- Portal dissection
- Division of the pancreatic neck
- SMV/portal vein mobilization
- Uncinate dissection
- Reconstruction
- Pancreaticojejunostomy
- Hepaticojejunostomy
- Versatility of the robotic platform
- Dissemination
- Potential oncologic advantages to robotic pancreatic resections
- Summary
- References
- Current Treatment for Small (&5 cm) Hepatocellular Carcinoma
- Evolving Roles for Ablation and Resection
- Introduction
- Outcomes after resection
- Thermal ablation
- RFA
- Resection versus RFA
- Resection and ablation
- Algorithm for care
- References
- Screening for Pancreatic Cancer
- Background
- The need for pancreatic cancer screening
- Benefit of early detection in other common cancers
- Potential difficulties with early detection screening
- Problems related to lead-time and length bias
- Problems related to screening test accuracy
- Who and how to screen?
- Groups at high risk of pancreatic adenocarcinoma
- High-risk premalignant lesions: PanINs and IPMNs
- Early mutations in pancreatic cancer development
- Screening tools for pancreatic cancer
- Current biomarkers for pancreatic cancer
- Potential novel biomarkers for pancreatic cancer
- Role of imaging in screening for pancreatic cancer
- Opportunities for prevention
- Practitioners and early detection
- Summary
- References
- Tissue Engineering
- Introduction
- Methods in tissue engineering
- Cells
- Biomaterials and scaffolds
- Vascularization
- Bioengineered constructs in surgery
- Skin
- Hollow structures: vessels, upper airways, and lower urinary tract
- Solid organs: the next frontier
- Heart
- Liver
- Kidney
- Pancreas
- Summary
- References
- Early Versus Delayed Surgery
- Introduction
- Pathogenesis
- Clinical manifestation
- Imaging
- Severity of acute cholecystitis and treatment
- Timing of cholecystectomy
- Open versus laparoscopic cholecystectomy
- Summary
- Acknowledgments
- References
- Gastrointestinal Stromal Tumors
- Who Should Get Imatinib and for How Long?
- Introduction
- Oncogenic kinase mutations and imatinib
- Metastatic GIST and imatinib
- Is imatinib effective in metastatic GIST?
- What is the optimal initial dosing scheme in metastatic GIST?
- Is higher-dose imatinib ever appropriate as first-line therapy?
- How is response to therapy optimally assessed?
- Does the type of mutation affect prognosis in advanced GIST?
- How long does imatinib treatment continue?
- Is there a role for surgery in metastatic patients treated with imatinib?
- What is appropriate therapy with evidence of disease progression?
- What is second-line therapy for patients progressing on imatinib?
- What agents are under investigation for imatinib-refractory GIST?
- Imatinib as adjuvant therapy
- Who is at greatest risk for recurrence following resection?
- Does adjuvant imatinib prolong RFS or OS compared with placebo?
- Do all patients benefit from adjuvant imatinib?
- Is a longer duration of adjuvant treatment beneficial?
- Does adjuvant imatinib affect development of imatinib resistance?
- Is salvage imatinib following recurrence effective?
- When is neoadjuvant imatinib indicated?
- Summary
- References
- Readmission After Surgery
- Introduction
- Readmission after medical and surgical hospitalization
- Defining and measuring readmission
- Hospital Readmissions Reduction Program
- Statistical issues for hospital profiling on readmission
- Predicting readmission
- Causes and prevention of readmission
- Summary
- References
- What Is Wrong with the Training of General Surgery?
- Key points
- Changes in surgical diseases
- Changes in operative technique
- Changes in management of certain disease processes
- Trauma
- Outpatient surgery
- Changes in work hours
- Changes in supervision and documentation
- Changes in resident expectations
- Lack of mentorship
- Improving general surgery training
- Summary
- References
- Aspirin, Clopidogrel, and the Surgeon
- Introduction
- Aspirin and thienopyridines
- Indications for antiplatelet therapy
- Consequences of cessation of antiplatelet therapy
- Current guideline recommendations regarding antiplatelet use and timing of surgery
- Summary
- References
- Islet Autotransplantation and Total Pancreatectomy
- Introduction
- Total pancreatectomy and the introduction of IAT
- Patient selection
- Surgical approach
- Pancreatectomy
- Pancreas processing
- Islet infusion
- Early postoperative glycemic management
- Results of total pancreatectomy with IAT
- Relief of pain
- Endocrine function
- Quality of life
- Special considerations
- Pediatric patients
- Malignancy
- Future directions
- Summary
- References
- Liver Transplantation for Metastatic Neuroendocrine Tumors
- Key points
- Epidemiology and background
- Classification
- Presentation
- Diagnosis
- Hormone activity
- Tumor histopathology
- Imaging
- Clinical management
- Resectable metastatic lesions
- Unresectable metastatic lesions
- Locoregional therapies
- Systemic therapies
- Surgical palliation
- Liver transplantation
- Patient selection for transplantation
- Timing of LT
- Prognosis: outcomes of LT
- Current practice in the United States
- Summary
- References
- Irreversible Electroporation
- A Novel Therapy for Stage III Pancreatic Cancer
- Background
- Mechanism of action
- Patient selection
- Technique
- Safety
- Efficacy
- Further investigation
- References
- Index
