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El. knyga: Surgical Decision Making in Acute Care Surgery

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  • Formatas: 280 pages
  • Išleidimo metai: 06-Aug-2020
  • Leidėjas: Thieme Medical Publishers Inc
  • Kalba: eng
  • ISBN-13: 9781638536420
Kitos knygos pagal šią temą:
Surgical Decision Making in Acute Care SurgeryDidesnis paveikslėlis
  • Formatas: 280 pages
  • Išleidimo metai: 06-Aug-2020
  • Leidėjas: Thieme Medical Publishers Inc
  • Kalba: eng
  • ISBN-13: 9781638536420
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Unique book provides comprehensive discussion of MIS versus traditional techniques in modern Acute Care Surgery

The combination of a surgeon shortage and poor access to emergency surgical care led to establishment of the Acute Care Surgery paradigm and subspecialty in 2003. Concurrently, minimally invasive approaches revolutionized surgical practice in the 21st century. In the U.S., acute care surgeons stand at the front line of patient care for emergency general surgery, trauma, and surgical critical care, and thus are positioned to positively impact healthcare delivery and costs. Surgical Decision Making in Acute Care Surgery by renowned surgeons Kimberly Davis and Raul Coimbra is the first text that comprehensively discusses when to use minimally invasive techniques and advanced technology versus traditional open procedures in acute traumatic and non-traumatic surgical emergencies.

The text begins with three opening chapters covering the background of the Acute Care Surgery subspecialty, anatomic and physiological considerations, and the impact of acute surgical illness on pre- and post-operative critical care decisions. Subsequent chapters outline surgical approaches for commonly encountered acute conditions. Trauma chapters cover interventions for cervical, blunt and penetrating abdominal, and thoracic injuries. Emergency general surgery topics run the gamut from appendicitis to emergency management of paraesophageal hernias and esophageal perforations. An impressive group of senior surgeons and younger rising stars in American surgery share their expertise throughout the book.

Key Highlights

  • Disease-specific chapters include epidemiology, pathogenesis, diagnostic tools, treatment strategies, surgical techniques, cost analyses, complications, and national guidelines where available
  • Subchapters feature expert commentary on preceding chapters, including clinical pearls and controversies (e.g. operative vs. nonoperative management)
  • In-depth discussion of surgical decision making encompasses the type of surgical approach, as well as indications and contraindications for MIS
  • The roles of MIS procedures such as laparoscopy, thoracoscopy, radiology-based percutaneous techniques, as well as endovascular surgery are examined

The quintessential resource on contemporary Acute Care Surgery practice, this is a must-read for residents, junior faculty, and practicing surgeons in this discipline.

This book includes complimentary access to a digital copy on https://medone.thieme.com.

Foreword xii
Preface xiii
Contributors xiv
1 The Definition of Acute Care Surgery
1(8)
Robert D. Becher
Raul Coimbra
Kimberly A. Davis
1.1 Drivers for the Acute Care Surgery Model
1(2)
1.2 Fellowship Training in ACS
3(1)
1.3 Surgeon Satisfaction with ACS
3(1)
1.4 Patient Throughput Improvements with ACS
3(1)
1.5 Care Delivery Models
4(1)
1.6 Standardizing Care: The Development of Grading Systems for ECS Diseases
4(1)
1.7 Improving Patient Outcomes after Emergency General Surgery
4(2)
1.8 Conclusion
6(3)
2 Anatomic and Physiological Considerations
9(5)
Bishwajit Bhattacharya
Kimberly A. Davis
2.1 Introduction
9(1)
2.2 Physiological Effects of Laparoscopy
9(1)
2.2.1 Physiologic Effects of Increased Intra-abdominal Pressure
9(1)
2.2.2 Physiologic Effects of Hypercarbia
10(1)
2.3 Anatomic Considerations
10(1)
2.4 Patient Populations
11(1)
2.4.1 Pediatric Patients
11(1)
2.4.2 Pregnant Patients
11(1)
2.4.3 Geriatric Patients
12(1)
2.5 Other Physiological Considerations of Minimally Invasive Surgery
12(1)
2.6 Future of Minimally Invasive Surgery
12(2)
3 Impact of Acute Surgical Illness on Critical Care Decisions Pre- and Postoperatively
14(20)
Lena M. Napolitano
Jay Doucet
3.1 Preoperative Critical Care
14(4)
3.1.1 Strategies to Optimize Organ Function and Intravascular Volume Preoperatively
14(4)
3.2 Postoperative Critical Care
18(16)
3.2.1 Role of the Surgical Team and Intensivist
18(1)
3.2.2 Resuscitation Goals
19(1)
3.2.3 Transfusion Strategies
20(2)
3.2.4 Management of Sepsis
22(2)
3.2.5 Respiratory Failure/ARDS
24(4)
3.2.6 Acute Kidney Injury
28(1)
3.2.7 Nutrition
28(1)
3.2.8 Pain, Agitation, and Delirium
28(2)
3.2.9 Prevention of Complications/Prophylaxis
30(4)
4 Cervical Trauma
34(12)
Aaron Richman
Clay Cothren Burlew
4.1 Penetrating Neck Trauma
34(3)
4.1.1 Tracheal Injury
35(1)
4.1.2 Cervical Esophageal Injury
36(1)
4.1.3 Cervical Vascular Injury
36(1)
4.2 Carotid Artery
37(1)
4.3 Vertebral Artery
38(1)
4.4 Subclavian Artery
38(1)
4.5 Blunt Neck Trauma
39(7)
4.5.1 Blunt Cerebrovascular Injury Management
39(6)
Expert Commentary on Cervical Trauma
45(1)
Timothy C. Fabian
5 Blunt Abdominal Trauma
46(16)
Morgan Schellenberg
Kenji Inaba
5.1 Introduction
46(1)
5.2 General Approach to Blunt Abdominal Trauma
46(1)
5.3 Management of Specific Injuries After Blunt Abdominal Trauma
47(3)
5.3.1 Solid Organ Injuries
47(1)
5.3.2 Diagnosis
47(1)
5.3.3 Management Strategy
48(1)
5.3.4 Surgical Techniques
48(2)
5.3.5 Complications
50(1)
5.4 Hollow Viscus Injuries
50(1)
5.4.1 Diagnosis
50(1)
5.4.2 Management Strategy
51(1)
5.4.3 Surgical Techniques
51(1)
5.5 Gastroesophageal (GE) Junction Injuries
51(2)
5.5.1 Stomach
51(1)
5.5.2 Duodenum
52(1)
5.5.3 Small Bowel and Colon
52(1)
5.5.4 Rectum
52(1)
5.5.5 Complications
53(1)
5.6 Pancreatic Injuries
53(1)
5.6.1 Diagnosis
53(1)
5.6.2 Management Strategy
53(1)
5.6.3 Surgical Techniques
53(1)
5.6.4 Complications
54(1)
5.7 Major Vascular Injuries
54(1)
5.7.1 Diagnosis
54(1)
5.7.2 Management Strategy
54(1)
5.7.3 Surgical Techniques
54(1)
5.7.4 Complications
55(1)
5.8 Diaphragm Injuries
55(1)
5.8.1 Diagnosis
55(1)
5.8.2 Management Strategy
55(1)
5.8.3 Surgical Techniques
55(1)
5.8.4 Complications
56(1)
5.9 Considerations for Abdominal Closure
56(1)
5.10 Conclusion
56(6)
Expert Commentary on Blunt Abdominal Trauma
61(1)
Robert C. Mackersie
6 Penetrating Abdominal Trauma
62(18)
Lyndsey E. Wessels
Michael J. Krzyzaniak
Matthew J. Martin
6.1 Introduction
62(1)
6.1.1 A Brief History of Penetrating Abdominal Trauma
62(1)
6.1.2 Epidemiology of Penetrating Abdominal Trauma
62(1)
6.1.3 Abdominal Anatomy
63(1)
6.2 Basic Principles of Penetrating Abdominal Trauma
63(1)
6.2.1 Mechanisms of Injury
63(1)
6.2.2 Initial Evaluation
63(1)
6.2.3 Basic Operative Principles
64(1)
6.3 Evaluation and Management of Abdominal Stab Wounds
64(5)
6.3.1 Evaluating for "Hard Signs to Operate"
64(1)
6.3.2 Selective Nonoperative Management
65(4)
6.3.3 Operative Principles Unique to Stab Wounds
69(1)
6.4 Evaluation and Management of Gunshot Wounds
69(4)
6.4.1 Evaluating for "Hard Signs to Operate"
69(1)
6.4.2 Selective Nonoperative Management
70(2)
6.4.3 Operative Principles Unique to Gunshot Wounds
72(1)
6.5 Laparoscopy in Penetrating Abdominal Trauma
73(1)
6.6 Special Scenarios
73(1)
6.6.1 Penetrating Abdominal Trauma in Pregnancy
73(1)
6.7 Damage Control Surgery
73(2)
6.7.1 Damage Control Abdominal Procedures
73(2)
6.7.2 Damage Control Resuscitation
75(1)
6.8 Conclusion
75(5)
Disclaimer
75(4)
Expert Commentary on Penetrating Abdominal Trauma
79(1)
Thomas Scalea
7 Thoracic Trauma
80(14)
Benjamin J. Moran
Katherine M. Kelley
James V. O'Connor
7.1 Introduction
80(1)
7.2 Initial Evaluation
80(1)
7.3 Indications for Operative Intervention
80(2)
7.3.1 Urgent/Emergent
80(2)
7.3.2 Thoracic Damage Control
82(1)
7.3.3 Elective
82(1)
7.4 Video-assisted Thoracoscopic Surgery (VATS)
82(1)
7.4.1 History of VATS
82(1)
7.4.2 Advantages and Indications for VATS
82(1)
7.4.3 VATS Operative Technique
82(1)
7.4.4 VATS Indications
82(1)
7.5 Contraindications and Complications of VATS
83(1)
7.6 Open Thoracic Surgery
83(4)
7.6.1 Operative Exposure
83(2)
7.6.2 Airway Management
85(1)
7.6.3 Operative Techniques
86(1)
7.7 Complications
87(1)
7.8 Cardiac Injuries
87(7)
7.8.1 Presentation and Evaluation
87(1)
7.8.2 Treatment
88(5)
Expert Commentary on Thoracic Trauma
93(1)
Gregory J. Jurkovich
8 Vascular Trauma
94(18)
Jason Pasley
Megan Brenner
Raul Coimbra
8.1 Introduction
94(1)
8.2 Diagnostic Testing
94(2)
8.3 Operative Considerations and Approaches
96(5)
8.3.1 Thoracic Aorta and Great Vessels
96(2)
8.3.2 Neck Exposure
98(1)
8.3.3 Carotid Artery
98(1)
8.3.4 Vertebral Artery Exposure
98(1)
8.3.5 Axillary Artery Exposure
98(1)
8.3.6 Brachial Artery
98(1)
8.3.7 Abdominal Aorta and the Inferior Vena Cava (IVC)
99(1)
8.3.8 Celiac Artery
99(1)
8.3.9 Superior Mesenteric Artery (SMA)
99(1)
8.3.10 Inferior Mesenteric Artery (IMA)
99(1)
8.3.11 Portal Vein (PV) and Superior Mesenteric Vein (SMV)
100(1)
8.3.12 Renal Artery and Vein
100(1)
8.3.13 Common Femoral Artery (CFA) and Vein
100(1)
8.3.14 Proximal SFA and Profunda Femoral Artery (PFA)
101(1)
8.3.15 Distal SFA
101(1)
8.3.16 Popliteal Artery
101(1)
8.4 Extremity Injuries
101(1)
8.5 Reconstructive Options
101(1)
8.5.1 Saphenous vein
101(1)
8.5.2 Polytetrafluoroethylene (PTFE)
101(1)
8.5.3 Other Conduits
101(1)
8.6 Venous Injuries
102(1)
8.7 Considerations After Repair of Extremity Injuries
102(1)
8.8 Role of Endovascular Interventions
102(5)
8.8.1 Shunts
105(1)
8.8.2 Tourniquets
105(1)
8.8.3 REBOA
106(1)
8.9 Conclusion
107(5)
Expert Commentary on Vascular Trauma
111(1)
David V. Feliciano
9 Appendicitis
112(20)
Edward Lineen
Yee Wona
Nicholas Namias
9.1 Introduction
112(1)
9.2 Epidemiology
112(1)
9.3 Pathogenesis
113(1)
9.4 Diagnosis
114(4)
9.4.1 Ultrasound
115(1)
9.4.2 Computed Tomography
116(2)
9.4.3 MRI
118(1)
9.5 Treatment
118(5)
9.5.1 Laparoscopic Versus Open Appendectomy
118(3)
9.5.2 Alternative Minimal Invasive Techniques
121(1)
9.5.3 Appendectomy Versus Antibiotics
122(1)
9.5.4 Uncomplicated
122(1)
9.5.5 Complicated Appendicitis
123(1)
9.6 Appendicitis in the Elderly
123(1)
9.7 Pregnancy
124(8)
Expert Commentary on Appendicitis
131(1)
Purvi P. Patel
Brendan Ringhouse
Christian Renz
Fred A. Luchette
10 Acute Cholecystitis
132(16)
Ciana H. Davidson
Eileen M. Bulger
10.1 Introduction
132(1)
10.2 Diagnostic Evaluation
132(1)
10.3 Indications and Timing for Operative Intervention
132(1)
10.4 Symptomatic Gallbladder disease
133(1)
10.4.1 Acute Cholecystitis
133(1)
10.4.2 Percutaneous Cholecystostomy
133(1)
10.4.3 Chronic Cholecystitis
133(1)
10.5 Complicated Biliary Disease
133(3)
10.5.1 Choledocholithiasis
133(1)
10.5.2 Cholangitis
134(1)
10.5.3 Gallstone Pancreatitis
134(1)
10.5.4 Gangrenous Cholecystitis
134(1)
10.5.5 Acalculous Cholecystitis
135(1)
10.5.6 External Compression of the Common Bile Duct: Mirizzi's and Lemmel Syndrome
135(1)
10.5.7 Hydrops
135(1)
10.5.8 Cholecystenteric Fistula (Gallstone Ileus)
135(1)
10.5.9 Porcelain Gallbladder
136(1)
10.6 Special Populations
136(1)
10.6.1 Cholecystitis in Pregnancy
136(1)
10.6.2 Cirrhosis
136(1)
10.6.3 Older population with Cholecystitis
136(1)
10.7 The Role of Minimally Invasive Surgery
136(3)
10.7.1 Role Of Intraoperative Cholangiogram (IOC), Intraoperative Ultrasound, and Indocyanine Green (ICG)
138(1)
10.8 Contraindications to an MIS Approach
139(1)
10.8.1 Open Cholecystectomy
139(1)
10.9 The Role for Nonoperative Management--
139(1)
10.9.1 Percutaneous Cholecystostomy
139(1)
10.9.2 Perforated Cholecystitis with Hepatic Abscess
139(1)
10.10 The Management of Complications
139(9)
Expert Commentary on Acute Cholecystitis
147(1)
Ronald Stewart
11 Acute Diverticulitis
148(12)
Maryanne L. Pickett
Joseph P. Minei
Michael W. Cripps
11.1 Introduction
148(1)
11.2 Indications for Operative Intervention
148(1)
11.3 Nonoperative Management
149(1)
11.4 Emergent Operation
149(1)
11.5 Nonemergent Surgery
149(1)
11.6 Role of Minimally Invasive Surgery
150(1)
11.7 Contraindications to MIS
151(1)
11.8 Open Management Strategies
152(1)
11.8.1 Hartmann's Procedure
152(1)
11.8.2 Primary Anastomosis (PA), With or Without, Diverting Loop Ileostomy (DLI)
152(1)
11.9 Damage Control
152(8)
11.9.1 Timing of Stoma Reversal
153(1)
11.9.2 Management of Postoperative Complications
153(6)
Expert Commentary on Acute Diverticulitis
159(1)
Frederick A. Moore
12 A Modern Approach to Complicated Pancreatitis
160(12)
Chris Javadi
Monica Dua
Brendan Visser
12.1 Terminology Matters
160(1)
12.2 Necrosis and Infection Exist in a Continuum
160(1)
12.3 Indications for Intervention
161(1)
12.4 What is Our Coal?
161(1)
12.5 Evolution of Strategies
161(5)
12.5.1 Open Necrosectomy
161(1)
12.5.2 Laparoscopic Debridement
161(1)
12.5.3 Retroperitoneal Debridement
161(2)
12.5.4 Two Trocar Technique
163(1)
12.5.5 Primary Percutaneous Drainage
164(1)
12.5.6 Transgastric Debridement
164(1)
12.5.7 Endoscopic Transgastric Debridement
164(2)
12.6 Conclusion
166(6)
Expert Commentary on A Modern Approach to Complicated Pancreatitis
171(1)
Peter Fagenholz
George C. Velmahos
13 Inflammatory/Infectious Bowel Disease
172(20)
Cigdem Benlice
Ipek Sapci
Scott R. Steele
13.1 Crohn's Disease
172(4)
13.1.1 Introduction
172(1)
13.1.2 Indications for Operative Intervention
172(2)
13.1.3 Special Considerations
174(1)
13.1.4 Minimally Invasive Approaches in Crohn's Disease
175(1)
13.1.5 Conclusion
176(1)
13.2 Ulcerative Colitis
176(1)
13.3 Clinical Manifestations
176(5)
13.3.1 Indications for Operative Intervention
177(1)
13.3.2 The Role of Minimally Invasive Surgery
178(1)
13.3.3 Contraindications to an MIS Approach
179(1)
13.3.4 Open Management Strategies
179(2)
13.3.5 The Management of Postoperative Complications
181(1)
13.4 Clostridium Difficile Colitis
181(11)
13.4.1 Indications for Operative Intervention
182(1)
13.4.2 The Role of Minimally Invasive Surgery
182(1)
13.4.3 Contraindications to an MIS Approach
183(1)
13.4.4 Open Management Strategies
183(1)
13.4.5 The Management of Postoperative Complications
183(1)
13.4.6 Conclusion
184(7)
Expert Commentary on Inflammatory/Infectious Bowel Disease
191(1)
Formosa Chen
Clifford Y. Ko
14 Castroduodenal Ulcers Requiring Surgery
192(14)
Robert D. Winfield
Marie L. Crandall
14.1 Introduction
192(1)
14.2 Risk Factors for Peptic Ulcer Disease
192(1)
14.3 Disease Presentation
192(1)
14.4 Diagnosis
192(1)
14.5 Management of Complicated Peptic Ulcer Disease
193(4)
14.6 Management of Hemorrhagic Peptic Ulcer Disease
197(1)
14.7 Postoperative management of Complicated Peptic Ulcer Disease
198(2)
14.8 Conclusion
200(6)
Expert Commentary on Castroduodenal Ulcers Requiring Surgery
205(1)
L. D. Britt
15 Intestinal Bowel Obstruction
206(10)
Bishwajit Bhattacharya
Adrian A. Maung
15.1 Introduction
206(1)
15.2 Background
206(1)
15.3 Diagnostic Workup
206(1)
15.4 Small Bowel Obstruction
206(4)
15.4.1 Indications for Operative Intervention
206(1)
15.4.2 Minimally Invasive Surgery for Small Bowel Obstruction
207(1)
15.4.3 Technical Considerations in Minimally Invasive Surgery for Small Bowel Obstruction
208(1)
15.4.4 Early Postoperative Obstruction
209(1)
15.5 Large Bowel Obstruction
210(6)
15.5.1 Operative Intervention for Large Bowel Obstruction
210(1)
15.5.2 Minimally Invasive Surgery for Large Bowel Obstruction
210(1)
15.5.3 Technical Considerations in Minimally Invasive Surgery for Large Bowel Obstruction
210(1)
15.5.4 Endoscopic Management of Large Bowel Obstruction
211(4)
Expert Commentary on Intestinal Bowel Obstruction
215(1)
Andrew B. Peitzman
16 Surgical Management of Incarcerated Hernias
216(12)
Jessica Koller Gorham
William S. Richardson
16.1 Introduction
216(1)
16.2 Epidemiology
216(1)
16.3 Differential Diagnosis
216(1)
16.4 Diagnosis
216(1)
16.5 Treatment
216(1)
16.6 inguinal Hernia
217(1)
16.6.1 Examples
217(1)
16.7 Umbilical Hernia
218(1)
16.8 Epigastric, Ventral, and Incisional Hernias
219(1)
16.9 Spigelian Hernia
220(1)
16.10 Diaphragmatic Hernia
220(2)
16.11 Flank Hernia
222(1)
16.12 Pelvic Hernia
222(1)
16.13 Internal Hernia
223(5)
Expert Commentary on Surgical Management of Incarcerated Hernias
227(1)
Brent Matthews
17 Mesenteric Ischemia
228(14)
James Becker
Todd W. Costantini
Joseph M. Galante
17.1 Introduction
228(1)
17.2 Anatomy of Mesenteric Circulation
229(1)
17.3 Diagnosis of Acute Mesenteric Ischemia
229(3)
17.3.1 History and Physical Examination
229(1)
17.3.2 Laboratory Analysis
230(1)
17.3.3 Imaging
230(2)
17.4 Treatment of Acute Mesenteric Ischemia
232(3)
17.4.1 Resuscitation
232(1)
17.4.2 Operative Exposure of the Mesenteric Vessels
232(1)
17.4.3 Thromboembolic Mesenteric Ischemia
233(1)
17.4.4 Veno-occlusive Mesenteric Ischemia
234(1)
17.4.5 Non-Occlusive Mesenteric Ischemia
235(1)
17.5 Ischemic Colitis
235(1)
17.6 Conclusion
236(6)
Expert Commentary on Mesenteric Ischemia
241(1)
David Spain
18 Esophageal Emergencies: Emergency Management of Paraesophageal Hernias and Esophageal Perforations
242(17)
Geoffrey P. Kohn
18.1 Introduction
242(1)
18.2 Paraesophageal Hernias
242(4)
18.2.1 Etiology
243(1)
18.2.2 Classification
243(1)
18.2.3 Incarceration and Strangulation
243(1)
18.2.4 Diagnosis
243(2)
18.2.5 Indications for Repair
245(1)
18.2.6 Management of Acute Gastric Obstruction
245(1)
18.2.7 Operative Technique
245(1)
18.3 Esophageal Perforation
246(13)
18.3.1 Etiology
246(1)
18.3.2 Investigations
247(1)
18.3.3 Management
248(3)
18.3.4 Outcomes
251(1)
18.3.5 Conclusion
252(5)
Expert Commentary on Esophageal Emergencies
257(2)
Steven DeMeester
Index 259
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