Sabiston Textbook of Surgery

The Biological Basis of Modern Surgical Practice

21st Edition - January 8, 2021
Editor: Courtney M. Townsend
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 6 4 0 6 2 - 6
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 6 4 0 6 4 - 0

For more than 80 years, Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice has been the go-to text for trainees and surgeons at all levels of experience… Read more

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For more than 80 years, Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice has been the go-to text for trainees and surgeons at all levels of experience for definitive guidance on every aspect of general surgery. As the oldest continuously published textbook of surgery in North America, this fully revised 21st Edition continues to provide the key information, essential teaching pearls, and completely updated content needed to make the most informed surgical decisions and achieve optimal outcomes for patients. Concisely written and evidence based throughout, it covers the breadth of material required for certification and practice of general surgery, highlighted by detailed, full-color intraoperative illustrations and high-quality video clips.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Preface
Foreword
Acknowledgments
Section I. Surgical Basic Principles
Introduction
Chapter 1. The Rise of Modern Surgery:: An Overview
The Beginnings
Knowledge of Anatomy
Control of Bleeding
Control of Pain
Control of Infection
Other Advances That Furthered The Rise of Modern Surgery
Ascent of Scientific Surgery
The Modern Era
Diversity
The Future
Chapter 2. Ethics and Professionalism in Surgery
Ethical Frameworks
A General Approach for Ethical Issue Resolution
Physician–Patient Relationship
Surgical Training and Innovation
Conclusion
Chapter 3. The Inflammatory Response
Components of the Inflammatory Response
Inflammation and the Critically ILL
Chapter 4. Shock, Electrolytes, and Fluid
History
Physiology of Shock
Problems with Resuscitation
Evolution of Modern Resuscitation
Current Status of Fluid Types
Future Resuscitation Research
Perioperative Fluid Management
Electrolytes
Chapter 5. Metabolism in Surgical Patients
Metabolic Science
Surgical Metabolism
Conclusion
Chapter 6. Wound Healing
Tissue Injury and Response
Wound-Healing Phases
Abnormal Wound Healing
Wound Dressings
Other Therapies
Fetal Wound Healing
Tissue Engineering
Gene and Stem Cell Therapy
New Horizons
Chapter 7. Regenerative Medicine
Stem Cell Sources
Bioengineering for Regenerative Medicine
Clinical Applications of Stem Cells
Conclusion
Chapter 8. Critical Assessment of Surgical Outcomes and Health Services Research
Evidence-Based Approach to Surgery
Appraising Surgical Evidence
Interpreting and Applying Evidence to Surgical Practice
Conclusion
Chapter 9. Safety in the Surgical Environment
Fostering a Culture of Safety Through Leadership
Local Organizational Structures to Promote Perioperative Safety
National and Health Care System–Level Safety Initiatives
System-Level Interventions Improve Safety
Conclusion
Section II. Perioperative Management
Introduction
Chapter 10. Principles of Preoperative and Operative Surgery
Principles of Surgical Evaluation
Assessment of Geriatric Surgical Patients
Systems Approach to Preoperative Evaluation
Preoperative Considerations and Care Protocols
Operating Room
Surgical Devices, Energy Sources, and Staplers
Potential Causes of Intraoperative Instability
Outpatient Surgery
Chapter 11. Surgical Infections and Antibiotic Use
Surgical Site Infections
Necrotizing Soft Tissue Infections
Specific Infections
Health Care–Associated Infections
Antibiotic Resistance
Clinically Important Pathogens
Chapter 12. Surgical Complications
Wound Complications
Thermal Regulation
Respiratory Complications
Cardiac Complications
Renal and Urinary Complications
Endocrine Dysfunction
Gastrointestinal Complications
Hepatobiliary Complications
Neurologic Complications
Ear, Nose, and Throat Complications
The Geriatric Patient and Frailty
Chapter 13. Surgery in the Geriatric Patient
Outcomes of Surgery in Older Adults
Frailty and Physiologic Decline
Preoperative Assessment and Decision-Making
Intraoperative and Postoperative Management
Transitions of Care
Surgery of Major Organ Systems
Chapter 14. Anesthesiology Principles, Pain Management, and Conscious Sedation
Pharmacologic Principles
Anesthesia Equipment
Patient Monitoring During and After Anesthesia
Preoperative Evaluation
Selection of Anesthetic Techniques and Drugs
Airway Management
General Anesthesia
Regional Anesthesia
Conscious Sedation
Postanesthesia Care
Acute Pain Management
Conclusion
Chapter 15. Emerging Technology in Surgery: Informatics, Electronics
Recent Significant Advances in Surgical Technology
Evolving Technologies in Surgery
Process of Innovation in Surgery
Innovations in Simulation: Surgical Training and Operative Planning
Conclusion
Chapter 16. Robotic Surgery
Preface
History
Preparing for Robotic Surgery
Current Status of Selected Robotic Operations
Conclusion
Section III. Trauma and Critical Care
Introduction
Chapter 17. Management of Acute Trauma
Overview and History
Trauma Systems
Injury Scoring
Prehospital Trauma Care
Initial Assessment and Management
Management of Specific Injuries
Rehabilitation
Chapter 18. The Difficult Abdominal Wall
Suture Material
Closure Technique
Prophylactic Mesh
Abdominal Fascial Dehiscence
Temporary Abdominal Closure
Management of the Open Abdomen and Assessing Readiness for Abdominal Closure
Pharmacologic Adjuncts to Closure
Synthetic Mesh Failure
Challenges in the Contaminated Field
Seroma and Skin Necrosis
Preparation for Abdominal Wall Reconstruction
Definitive Repair—Creating a Dynamic Abdominal Wall
Rives-Stoppa-Wantz and Transversus Abdominis Release Techniques
Perioperative Considerations
Summary
Chapter 19. Emergency Care of Musculoskeletal Injuries
Epidemiology of Orthopedic Injuries
Terminology
Fixation Principles
Patient Evaluation
Time-Dependent Orthopedic Injuries
Acute Compartment Syndrome
Pelvic Ring Disruption
Spinal Injuries
Dislocations
Vascular Injuries
Common Long Bone Fractures
Challenges and Complications
Postoperative Mobilization
Summary
Chapter 20. Burns
General Considerations
Burn Units
Pathophysiology of Burns
Initial Treatment of Burns
Inhalation Injury
Wound Care
Minimizing Complications
Nutrition
Electrical Burns
Chemical Burns
Summary
Chapter 21. Bites and Stings
Snakebites
Mammalian Bites
Arthropod Bites and Stings
Marine Bites and Stings
Chapter 22. Surgical Critical Care
Neurologic System
Cardiovascular System
Respiratory System
Gastrointestinal System
Hepatic System
Renal System
Hematologic System
Endocrine System
Infectious Diseases
Special Issues
Chapter 23. Bedside Surgical Procedures
Rationale for Bedside Surgical Procedures
Taking the Operating Room to the Bedside
Safety Practices for Bedside Surgical Procedures
Selection of Patients for Bedside Surgical Procedures
Bedside Laparotomy
Tracheostomy
Percutaneous Endoscopic Gastrostomy
Bronchoscopy
Chapter 24. The Surgeon’s Role in Mass Casualty Incidents
History
Key Definitions
Mascal Key Principles
Critical Mascal Lessons Learned
Mascal Management and the Surgeon’s Role in Triage
Conclusions
Section IV. Transplantation and Immunology
Introduction
Chapter 25. Transplantation Immunobiology and Immunosuppression
The Immune Response
Transplant Immunity
Immunosuppression
Tolerance
Xenotransplantation
New Areas of Transplantation
Conclusion
Chapter 26. Liver Transplantation
History
Indications
Contraindications
Meld and Allocation
Donor Selection
Preoperative Evaluation
Surgical Considerations
Postoperative Management
Complications and Their Treatment
Immunosuppression
Living Donor Liver Transplantation Including Donor Selection
Pediatric Liver Transplantation
New Technologies Including Machine Perfusion
Chapter 27. Kidney and Pancreas Transplantation
Historical Perspective
Kidney Transplantation
Pancreas Transplantation
Islet Transplantation
Chapter 28. Small Bowel Transplantation
History
Indications for Intestine Transplantation
Evaluation
Immunosuppression
Complications
Outcomes
Conclusion
Section V. Surgical Oncology
Introduction
Chapter 29. Tumor Biology and Tumor Markers
Epidemiology
Tumor Biology
Carcinogenesis
Tumor Markers
Chapter 30. Tumor Immunology and Immunotherapy
Overview of Tumor Immunology
Immunotherapy
Conclusion
Chapter 31. Melanoma and Cutaneous Malignancies
Melanoma
Nonmelanoma Skin Cancers
Chapter 32. Soft Tissue Sarcoma
Epidemiology
Core Concepts
Trunk and Extremity Sarcoma
Retroperitoneal and Visceral Sarcoma
Summary
Chapter 33. Bone Tumors
Overview
Bone Microenvironment
Bone Macroenvironment
Biopsy
Staging
Oncologic Resection
Skeletal Reconstruction
Benign Bone Tumors
Skeletal Sarcomas
Bone Metastases
Conclusion
Section VI. Head and Neck
Introduction
Chapter 34. Head and Neck
Normal Histology
Epidemiology
Carcinogenesis
Staging
Clinical Overview
Anatomic Sites
Head and Neck Reconstruction
Section VII. Breast
Introduction
Chapter 35. Diseases of the Breast
Anatomy
Microscopic Anatomy
Breast Development and Physiology
Diagnosis of Breast Disease
Breast Imaging
Identification and Care of High-Risk Patients
Benign Breast Tumors and Related Diseases
Epidemiology and Pathology of Breast Cancer
Staging of Breast Cancer
Surgical Treatment of Breast Cancer
Treatment of Ductal Carcinoma in Situ
Radiation Therapy for Breast Cancer
Systemic Therapy for Breast Cancer
Treatment of Locally Advanced and Inflammatory Breast Cancer
Treatment of Special Conditions
Chapter 36. Breast Reconstruction
Breast Conservation Therapy—Oncoplastic Techniques
Reconstruction After Mastectomy
Nipple-Areola Reconstruction
Revision Surgery—Aesthetics of Breast Reconstruction
Conclusion
Section VIII. Endocrine
Introduction
Chapter 37. Thyroid
Disclosures
History of Thyroid Surgery
Thyroid Embryology and Anatomy
Thyroid Histology and Physiology
Thyroid Biomarkers
Thyroid Imaging
Hypothyroidism
Hyperthyroidism
Nontoxic Goiter
Thyroid Nodule
Thyroid Cancer
Thyroidectomy
Chapter 38. The Parathyroid Glands
History of the Parathyroid Glands
Embryology of the Parathyroid Glands
Surgical Anatomy of the Parathyroid Glands
Histology of the Parathyroid Glands
Parathyroid Physiology
Primary Hyperparathyroidism
Secondary and Tertiary Hyperparathyroidism
Hyperparathyroidism-Induced Hypercalcemic Crisis
Parathyroid Cancer
Familial Primary Hyperparathyroidism
Reoperative Neck Surgery for Persistent or Recurrent Hyperparathyroidism
Chapter 39. Endocrine Pancreas
Embryology of the Endocrine Pancreas
Histomorphology of Islets
Endocrine Physiology
Pancreatic Neuroendocrine Tumors
Noninsulinoma Pancreatogenous Hypoglycemia Syndrome
Endocrine Complications of Surgical Therapy
Surgical Treatment of Diabetes
Chapter 40. The Adrenal Glands
History
Anatomy and Embryology
Normal Histopathology
Biochemistry and Physiology
Adrenal Insufficiency
Diseases of the Adrenal Cortex
Diseases of the Adrenal Medulla
Other Adrenal Diseases
Technical Aspects of Adrenalectomy
Chapter 41. The Multiple Endocrine Neoplasia Syndromes
Multiple Endocrine Neoplasia Type 1
Multiple Endocrine Neoplasia Type 2
Conclusion
Section IX. Esophagus
Introduction
Chapter 42. Esophagus
Anatomy
Physiology
Diagnosis and Management of Esophageal Motility Disorders
Diverticular Disorders
Gastroesophageal Reflux Disease
Acquired Benign Disorders of the Esophagus
Benign and Rare Tumors of the Esophagus
Esophageal Cancer
Summary
Chapter 43. Gastroesophageal Reflux Disease and Hiatal Hernia
Gastroesophageal Reflux Disease
Paraesophageal Hernia
Summary
Section X. Abdomen
Introduction
Chapter 44. Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum and Retroperitoneum
Abdominal Wall And Umbilicus
Peritoneum and Peritoneal Cavity
Mesentery and Omentum
Retroperitoneum
Chapter 45. Hernias
Inguinal Hernias
Femoral Hernias
Special Problems
Ventral Hernias
Unusual Hernias
Chapter 46. Acute Abdomen
Anatomy and Physiology
History
Physical Examination
Laboratory Studies
Diagnostic Imaging
Intraabdominal Pressure Monitoring
Differential Diagnosis
Preparation for Emergency Operation
Special Patient Populations
Summary
Chapter 47. Acute Gastrointestinal Hemorrhage
Acute Management of Patients With Gastrointestinal Hemorrhage
Specific Causes of UGIB
Acute Lower Gastrointestinal Hemorrhage
Chapter 48. Morbid Obesity
Obesity: The Magnitude of the Problem
Pathophysiology and Associated Medical Problems
Medical Versus Surgical Therapy
Bariatric Surgery Mechanism of Action
Preoperative Evaluation and Selection
Operative Procedures
Postoperative Care and Follow-Up
Bariatric Surgery Results
Complications of Bariatric Surgery
Reoperative Surgery
Endoscopic Procedures in Bariatric Surgery
Controversies in Bariatric Surgery
Conclusion
Chapter 49. Stomach
Anatomy
Physiology
Peptic Ulcer Disease
Stress Gastritis
Postgastrectomy Syndromes
Gastric Cancer
Other Gastric Lesions
Chapter 50. Small Intestine
Embryology
Anatomy
Physiology
Motility
Endocrine Function
Immune Function
Obstruction
Inflammatory and Infectious Diseases
Neoplasms
Diverticular Disease
Miscellaneous Problems
Chapter 51. The Appendix
Anatomy and Embryology
Videos
Appendicitis
Treatment of Appendicitis
Nonoperative Treatment of Uncomplicated Appendicitis
Appendicitis in Special Populations
Neoplasms of the Appendix
Chapter 52. Colon and Rectum
Embryology of the Colon and Rectum
Anatomy of the Colon, Rectum, and Pelvic Floor
Physiology of the Colon
Preoperative Evaluation
Enhanced Recovery Protocols
Diverticular Disease
Large Bowel Obstruction
Colonic Pseudo-Obstruction
Inflammatory Bowel Disease
Infectious Colitis
Other Colonic Infections
Ischemic Colitis
Neoplasia
Colorectal Polyps
Staging
Surgical Treatment of Colorectal Cancer
Obstructing Colon Cancers
Rectal Cancer
Pelvic Floor Disorders and Constipation
Chapter 53. Anus
Anatomy
Common Benign Disorders of the Anus
Neoplasms
Chapter 54. The Liver
Historical Perspective
Anatomy and Physiology
Portal Hypertension
Infectious Diseases
Neoplasms
Hemobilia
Viral Hepatitis and the Surgeon
Chapter 55. Biliary System
Anatomy and Physiology
Biliary Tree Pathophysiology
Benign Biliary Disease
Malignant Biliary Disease
Metastatic and Other Tumors
Chapter 56. Exocrine Pancreas
Anatomy
Embryology
Physiology
Acute Pancreatitis
Chronic Pancreatitis
Cystic Neoplasms of the Pancreas
Adenocarcinoma of the Exocrine Pancreas
Pancreatic Trauma
Chapter 57. The Spleen
Splenic Anatomy
Splenic Function
Splenectomy
Section XI. Chest
Introduction
Chapter 58. Lung, Chest Wall, Pleura and Mediastinum
Anatomy
Selection of Patients for Thoracic Operations
Lung
Lung Cancer
Trachea
Pulmonary Infections
Massive Hemoptysis
Emphysema and Diffuse Lung Disease
Pulmonary Metastases
Miscellaneous Lung Tumors
Chest Wall
Thoracic Outlet Syndrome
Pleura
Mediastinum
Primary Mediastinal Cysts
Primary Mediastinal Neoplasms
Chapter 59. Congenital Heart Disease
History and Other Considerations
Pathways for Practicing Congenital Heart Surgery
Anatomy, Terminology, and Diagnosis
Perioperative Care
Lesion Overview
Single Ventricle
Miscellaneous Anomalies
Summary
Chapter 60. Acquired Heart Disease: Coronary Insufficiency
Coronary Artery Anatomy and Physiology
History of Coronary Artery Bypass Surgery
Atherosclerotic Coronary Artery Disease
Clinical Manifestations and Diagnosis of Coronary Artery Disease
Indications for Coronary Artery Revascularization
Adjuncts to Coronary Artery Bypass Grafting
Postoperative Care
Alternative Methods for Myocardial Revascularization
Mechanical Complications of Coronary Artery Disease
Coronary Artery Bypass Grafting and Special Populations of Patients
Chapter 61. Acquired Heart Disease: Valvular
History of Heart Valve Surgery
Valve Anatomy
Etiology and Pathology of Valvular Heart Disease
Pathophysiology of Valvular Heart Disease
Valve Disease Syndromes
Aortic Stenosis
Operative Approaches
Section XII. Vascular
Introduction
Chapter 62. The Aorta
Embryology, Anatomy, and Nomenclature
Pathology, Management, and Outcomes
Specific Considerations in Surgical Management
Chapter 63. Peripheral Arterial Disease
Epidemiology and Demographics
Patient Presentations and Natural History
Pathophysiology and Anatomy
Evaluation of the Patient with Peripheral Artery Disease
Medical Management
Key Management Concepts: Wifi, Glass, Tap and Plan
Endovascular Versus Open Surgical Therapy
Surveillance
Assessment of Outcomes
Chapter 64. Vascular Trauma
Mechanism of Injury and Pathophysiology
Clinical Presentation
Diagnosis
Minimal Vascular Injury and Nonoperative Management
Endovascular Management
Open Surgical Management
Specific Injuries
Postoperative Management
Outcomes and Follow-Up
Training and Preparation for Successful Management
Chapter 65. Venous Disease
Videos
Anatomy
Venous Insufficiency
Deep Venous Thrombosis
Superficial Thrombophlebitis
Conclusion
Chapter 66. The Lymphatics
Embryology and Anatomy
Function and Structure
Pathophysiology and Staging
Differential Diagnosis
Classification
Diagnostic Tests
Therapy
Chylothorax
Chyloperitoneum
Tumors of the Lymphatics
Section XIII. Specialties in General Surgery
Introduction
Chapter 67. Pediatric Surgery
Neonatal Physiology
Fluids, Electrolytes, and Nutrition
Head and Neck Lesions
Extracorporeal Life Support
Diaphragmatic Conditions
Bronchopulmonary Malformations
Alimentary Tract Conditions
Hepatopancreaticobiliary Conditions
Abdominal Wall Conditions
Chest Wall Deformities
Genitourinary Tract Conditions
Pediatric Solid Tumors
Pediatric Trauma
Chapter 68. Neurosurgery
Intracranial Dynamics
Cerebrovascular Disorders
Central Nervous System Tumors
Primary Brain Tumors
Traumatic Brain Injury
Degenerative Disorders of The Spine
Functional And Stereotactic Neurosurgery
Hydrocephalus
Pediatric Neurosurgery
Central Nervous System Infections
Chapter 69. Plastic Surgery
Reconstructive Techniques
Pediatric Plastic Surgery
Plastic Surgery of the Head and Neck
Breast Surgery
Abdominoplasty
Gender Affirmation Surgery
Wound Management/Pressure Wounds
Reconstruction of the Lower Extremity
Conclusion
Chapter 70. Hand Surgery
Basic Anatomy
Examination and Diagnosis
Principles of Treatment
Trauma
Infections
Compartment Syndrome, High-Pressure Injection Injuries, and Extravasation Injuries
Tenosynovitis
Nerve Compression Syndromes
Tumors
Congenital Anomalies
Osteoarthritis and Rheumatoid Arthritis
Contractures
Future Directions in Hand Surgery
Conclusion
Chapter 71. Gynecologic Surgery
Female Reproductive and Other Pelvic Anatomy
Common Vulva and Vaginal Surgical Diseases and Procedures
Common Cervical Surgical Diseases and Procedures
Common Uterine Surgical Diseases and Procedures
Common Fallopian Tube/Ovarian Surgical Diseases and Procedures
Summary
Chapter 72. Surgery in the Pregnant Patient
Physiologic Changes of Pregnancy
Safety Concerns in Pregnancy
Prevention of Preterm Labor
Abdominal Pain and the Acute Abdomen in Pregnancy
Minimally Invasive Surgery in Pregnancy
Breast Masses in Pregnancy
Surgery for Diseases in Pregnancy
Trauma in Pregnancy
Control of Major Hemorrhage
Pregnancy After Major Abdominal Surgery
Summary
Chapter 73. Fetal Surgery
The Birth of a New Surgical Specialty
Prenatal Pathophysiologic Considerations and Rationale
Maternal Considerations and Morbidity
Fetal Surgery by System
Novel Therapies and Future Directions in Fetal Medicine and Surgery
Chapter 74. Urologic Surgery
Urologic Anatomy for the General Surgeon
Endoscopic Urologic Surgery
Urologic Infectious Disease
Voiding Dysfunction, Neurogenic Bladder, Incontinence, and Benign Prostatic Hyperplasia
Male Reproductive Medicine and Sexual Dysfunction
Urolithiasis
Urologic Trauma
Nontraumatic Urologic Emergencies
Urologic Oncology
Index

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Courtney M. Townsend