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Surgical Treatment
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Surgical Treatment
Evidence-Based and Problem-Oriented
Holzheimer
René G
Mannick
John A
1
Martin-Luther University Halle-Wittenberg, Wallbergstraße 15a, D-82054 Sauerlach, Germany
2
Department of Surgery, Brigham and Womens Hospital, Harvard University Medical School, 75 Francis Street, Boston MA 02115, USA
W. Zuckschwerdt Verlag
3-88603-714-2
2001
© 2001
W. Zuckschwerdt Verlag GmbH
surgery
Table of Contents
Preface
Authors
Part I Esophagus
Carcinoma of the esophagus and gastro-esophageal junction
Toni Lerut
Epidemiology – etiology – pathology
Diagnosis
Staging and classification
Surgical treatment
References
Radiation therapy of esophageal cancer
Abram Recht, M.D.
Introduction
Inoperable cancers: chemoradiotherapy versus supportive care
Inoperable cancers: radiotherapy versus chemoradiotherapy
Resectable cancers: radiotherapy versus surgery
Resectable cancers: preoperative or postoperative radiotherapy versus surgery alone
Resectable cancers: preoperative chemotherapy and radiotherapy versus surgery alone
Discussion
Conclusions
References
Gastro-esophageal reflux disease (GERD)
P Gorecki, M.D.
Definition, epidemiology and pathogenesis of GERD
Diagnostic tests
Therapy
Nissen Fundoplication
Partial fundoplications
Summary
References
Peptic strictures of the esophagus
Christopher M Schlachta, Eric C Poulin, Joseph Mamazza, and Pieter A Seshadri
Pathophysiology
Diagnosis
Management
Mallory-Weiss Syndrome
Diagnosis and pathogenesis
Therapy
References
Instrumental perforation of the esophagus
Jarmo A Salo and Eero I T Sihvo
Causes
Pathogenesis
Prognosis
Diagnosis
Treatment
References
Part II Stomach-Duodenum
Preoperative staging for gastric cancer
J. R Siewert, M.D. and A. Sendler, M.D.
Primary tumor, T-category
Nodal involvement, N-category
Distant metastases - M-category
References
Surgical management of gastric cancer
Simon Msika, Grégoire Deroide, and Reza Kianmanesh
Surgical treatment
Non surgical treatment
References
Surgery for gastric remnant carcinoma following Billroth II gastrectomy
L Filez and F Penninckx
Definition
Incidence
Pathogenesis
Symptoms
Diagnosis
Staging
Treatment
Complications
Prognosis
Prevention
References
Malignant tumors of the duodenum
Pierre-Louis Fagniez and Nelly Rotman
Incidence
Clinical presentation
Diagnosis
Preoperative staging
Treatment
Prognostic assessment
References
Primary gastric lymphoma
V Speranza and D Lomanto
Introduction
Pathology
Staging
Clinical signs and diagnosis
Prognostic factors
Therapeutic modalities
Controversies
Eradication Therapy
Conclusions
References
Benign tumors of the duodenum and stomach
Peter M Y Goh, M.D. and Jorge E Lenzi, M.D.
Introduction
Classification
Presenting symptoms and diagnosis
Treatment Options
References
Management of perforated duodenal ulcer
Andrew G Hill, M.D. Fracs
Introduction
Pathogenesis and epidemiology
Diagnosis
Risk Stratification
Treatment
Conclusion
References
Gastric surgery for morbid obesity
Edward E Mason, M.D.
Weight control mechanisms
HCl and stomal ulceration
The informed patient and operative choice
Malnutrition avoidance; emesis no, anamnesis yes
References
Duodenal diverticula
Jerry M Shuck, M.D. and Anthony Stallion, M.D.
Clinical implications
Surgical implications
Surgical challenges
Conclusions
References
Part III Small Bowel
Adenocarcinoma of the small bowel
Alfred I Neugut, M.D., Michael R Marvin, Ph.D., and John A Chabot, M.D.
Introduction
Incidence
Etiology
Clinical presentation and diagnosis
Stage/grade distributions
Treatment
Conclusions
References
Small bowel obstruction
M. N Kulaylat and R. J Doerr
Definition, classification, and etiology
Pathophysiologic changes
Diagnosis of acute small bowel obstruction
Treatment of acute small bowel obstruction
References
Mesenteric ischemia
Ulf Haglund, M.D.
Definition, pathogenesis and epidemiology
Clinical stages
Diagnosis
Treatment
References
Surgical management of Crohn's disease
Scott A Strong, M.D.
Introduction
Classifications, operative incidence, and operative indications
Operative options
Conclusions
References
Surgical therapy of recurrent Crohn's disease
H.J. Buhr and A.J. Kroesen
Definition of recurrence
Factors influencing recurrence
Surgical principals in recurrent Crohn's disease
Conclusion
References
Meckel's diverticulum
Anthony Stallion, M.D. and Jerry M Shuck, M.D.
Epidemiology
Embryology and anatomy
Clinical presentation
Diagnosis
Management
Conclusion
References
Postoperative enterocutaneous fistula
Timothy A Pritts, M.D., David R Fischer, M.D., and Josef E Fischer, M.D.
Introduction
Definition and classification
Diagnosis
Treatment
References
Short bowel syndrome
Malcolm K Robinson, M.D. and Douglas W Wilmore, M.D.
Definition and pathogenesis
Initial treatment and nutritional management
Growth factors
Surgical treatments and intestinal transplantation
Designing a treatment plan based on predicted outcome
Conclusion
References
Intestinal transplantation
Christoph Troppmann, M.D. and Rainer W G Gruessner, M.D.
Introduction
Intestinal failure and indications for intestinal and multivisceral transplantation
Contraindications
Preoperative evaluation
Operative technique (basic steps)
Postoperative management
Immunosuppression
Posttransplant complications
Clinical intestinal transplant outcome
References
Part IV Colon
Colorectal cancer
A. Shankar and I. Taylor
Incidence
Screening
Surgical treatment of colorectal cancer
Emergency surgery
Adjuvant treatment
Advanced disease
Liver resection
Conclusion
References
Surgical management of rectal carcinoma
Lars Påhlman
Introduction
Local control
Functional outcome
Conclusion
References
Locoregional recurrence of rectal cancer
Johan N Wiig, M.D. and Odd Søreide, M.D.
Definition, reporting and extent of disease
Natural history of LR
Detection and preoperative assessment
Treatment
Conclusion
References
Benign tumors of the colon and rectum
M. Zuber and F. Harder
NON-NEOPLASTIC POLYPS
Hyperplastic polyps
Inflammatory polyps
Lymphoid polyps
NEOPLASTIC EPITHELIAL POLYPS
Mesenchymal lesions
Neuroma
Angioma
References
Diverticulitis
Moshe Schein, M.D. and Ramesh Paladugn, M.D.
Introduction
Pathophysiology
Clinical manifestation
Level of evidence
Diagnosis
Non operative treatment
Management of ‘diverticular abscesses’
Emergency surgery for acute diverticulitis
Emerging therapies
After the emergency
Conclusions
References
Obstruction of the colon (benign pathology)
J.J. Tuech, M.D., P. Pessaux, and J.P. Arnaud, M.D.
Volvulus of the colon
Sigmoid diverticulitis
Others
References
Surgical management of ulcerative colitis
F.A. Frizelle, MBChB and M.J. Burt, MBChB
Introduction
Indications for surgery
Surgical options
Special circumstances
Conclusion
References
Lower gastrointestinal tract bleeding: a problem based approach
J Martin Perez, M.D. and Stephen M Cohn, M.D.
Clinical presentation
History and physical examination
Diagnosis and therapeutics
References
Management of complications of colonoscopy
Stephen M Kavic, M.D. and Marc D Basson, M.D.
Perforation
Hemorrhage
Diagnosis
Management
Conclusion
References
Appendicitis
Per-Olof Nyström, M.D.
Introduction
Increasing the diagnostic accuracy
Clinical diagnosis of appendicitis
Specific components of the appendectomy
Antibiotic prophylaxis and therapy
Primary closure of the wound or delayed
The appendix stump
Laparoscopic appendectomy
Comments
References
Part V Anal
Anal fissure
M. Jonas and J.H. Scholefield
Introduction
Pathogenesis
Treatment
The future
References
Rectal prolapse
Christian T Hamel, M.D. and Steven D Wexner, M.D.
Definition, pathogenesis
Diagnosis
Differential diagnosis
Conclusion
References
Anal abscess and fistula
H.J. Mappes and E.H. Farthmann
Classification and pathological anatomy
Symptoms
Diagnosis
Therapy
Anal fistula
Transsphincteric fistulae
Extrasphincteric fistulae
Recto-vaginal fistulae
References
Complicated anorectal sepsis
P.A. Gervaz and S.D. Wexner
Introduction
Anorectal sepsis in Crohn's disease
Surgical management
Anorectal sepsis in AIDS
Anorectal sepsis in patients with hematologic diseases
Postoperative anorectal sepsis
References
Anal incontinence
Charles B S Tsang and Francis Seow-Choen
Introduction
The continence mechanism
Causes of anal incontinence
Current treatment of anal incontinence
Conclusion
References
Surgical Treatment of Haemorrhoids
René G Holzheimer
Classification
Pathogenesis
Symptoms
Differential diagnosis
Treatment options for haemorrhoids include
Treatment modalities for haemorrhoids
Additional treatment for haemorrhoids
References
Part VI Hepatic
Hepatocellular cancer: resection or transplantation
Galal El-Gazzaz, Janek Dmitrewski, and Paul McMaster
Resection or transplantation for hepatocellular carcinoma
Conclusions
References
Multimodality treatment for hepatocellular carcinoma
Zhao-You Tang
General consideration of HCC
Staging of HCC
Evolution of HCC treatment
Selection of treatment modality
Implication of multimodality combination treatment for HCC
HAL combined with HAI and followed by resection
TACE and followed by resection
Resection followed by TACE and other treatment
Multimodality treatment of recurrent HCC
TACE, PEI and their combination
Other treatment modalities
Conclusion
References
Resection of recurrent liver cancer
W. Lamadé and Ch. Herfarth
Tumor recurrence after resection of liver metastases
Interval between the resection of the primary tumor and liver metastases surgery
Interval between liver resection and recurrent liver metastases
Tumor spread at the time of liver metastases recurrence
Factors influencing the rate of recurrence
Perioperative effects on recurrence rates
Recurrence after repeat hepatic resection
Hepatic recurrence in patients with non-colorectal primary tumors
Surgical technique
Morbidity and mortality
Long-term survival after repeat resection of liver metastases
Prognostic criteria after first and second liver metastases resection
Conclusion
References
Repeat hepatectomy for primary liver cancer
R. Adam, G. Marin-Hargreaves, D. Azoulay, D. Castaing, F. Meriggi, and H. Bismuth
Introduction
Frequency of recurrence
Diagnosis of recurrence
Prevention of recurrence
Repeat liver resection
Conclusion
References
Percutaneous cryosurgery of irresectable liver tumors
R. Adam, G. Marin Hargreaves, F. Meriggi, and H. Bismuth
Introduction
History and principles
Cryosurgery technique
Specific aspects of percutaneous cryosurgery
Indications
Results
Complications
Conclusion
References
Liver transplantation
I. M Sauer, W. O Bechstein, and P. Neuhaus
Definition, indications and contraindications for liver transplantation
Preoperative evaluation
Operative technique in liver transplantation
Postoperative management
Comment
References
Portal hypertension
John C Li and J.M. Henderson
Historical perspective
Anatomy and physiology
Pathophysiology
Ascites
Budd-Chiari syndrome
References
Pyogenic and amebic liver abscess
Iskender Sayek, M.D. and Demirali Onat, M.D.
Pyogenic abscess
Amebic liver abscess
References
Hydatid liver disease
Jean-Luc Jourdan, M.D. and David L Morris, M.D.
Biology and epidemiology
Diagnosis
Treatment
Prevention
References
Part VII Biliary
Cholangiocarcinoma
Bryan M Clary, William R Jarnagin, and Leslie H Blumgart
Introduction
Demographics and Etiology
Pathology
Clinical Presentation and Diagnosis
Treatment
References
Klatskin tumors
Keith D Lillemoe, M.D.
Definition, pathogenesis and epidemiology
Diagnosis and Staging
Surgical Treatment
Adjuvant therapy
Conclusion
References
Primary sclerosing cholangitis
J. E J Krige, P. C Bornman, and J. Terblanche
Definition
Incidence
Pathogenesis
Diagnosis
Clinical Presentation
Biochemical abnormalities
Cholangiography
Pathology
Medical therapy
Endoscopic treatment
Surgical treatment
Liver transplantation
Conclusion
References
Cholecystitis and Cholelithiasis
René G Holzheimer
Pathogenesis and prevalence
Indications and contra-indications for laparoscopic cholecystectomy
Laparoscopic cholecystectomy for acute cholecystitis
Conversion to open treatment
Randomized studies comparing open cholecystectomy and laparoscopic cholecystectomy
Randomized studies comparing mini-cholecystectomy with open cholecystectomy or laparoscopic cholecystectomy
Randomized studies comparing different techniques in pneumoperitoneum
Randomized studies in pain treatment and laparoscopic cholecystectomy
Common bile duct exploration and clearance - randomized studies
Antibiotic prophylaxis and laparoscopic cholecystectomy - randomized studies
Surgical technique and laparoscopic cholecystectomy - randomized studies
Summary
References
Acute cholangitis
Chi-Leung Liu and Sheung-Tat Fan, M.D.
Introduction
Diagnosis
Management
Summary
References
Acute acalculous cholecystitis
Philip S Barie, M.D.
Abstract
Introduction
Patterns of clinical illness
Pathogenesis
Diagnosis
Treatment
References
Laparoscopic biliary injury
Raymond Aerts and Freddy Penninckx
Mechanism and type of injury
Diagnosis
Treatment BTI at the time of laparoscopic cholecystectomy
Management of BTI diagnosed after laparoscopic cholecystectomy
Outcome
References
Part VIII Pancreas
Pancreatic cancer
Dieter Birk and Hans G Beger
Introduction
Epidemiology
Symptomatology and tumor biology
Diagnostic approach
Staging of pancreatic cancer
Indication for surgery and technical approach
Extended resection in pancreatic cancer
Prognostic factors ()
The role of surgery in the palliation of pancreatic cancer
Summary
References
Periampullary carcinoma
L Fernandez-Cruz
Definition
Epidemiology, clinical characteristics and diagnosis
Prognostic Factors
Staging
Surgery
Adjuvant Therapy
References
Cystic tumors of the pancreas
Ramon E Jimenez, M.D., Carlos Fernandez-del Castillo, M.D., and Andrew L Warshaw, M.D.
Differential diagnosis
Tumor characteristics and treatment
References
Acute pancreatitis
Pierre-Louis Fagniez and Nelly Rotman
Acute pancreatitis
Etiology - pathogenesis
Diagnostic
Classification
Severity
Treatment
References
Early complications of severe acute pancreatitis
C Bassi, M Falconi, G Butturini, and P Pederzoli
Early complications
Early surgery
Biliary obstruction
Multi-organ failure (MOF), failure to improve, deterioration
Early infected necrosis
Hemorrhage and peritonitis
Extensive sterile necrosis
Rupture of Wirsung duct
Conclusion
References
Fistulas of the pancreas
Roger Saadia, M.D.
Introduction
Pancreatico-cutaneous fistula
Pseudocysts
Pancreatic ascites and pleural effusions
Pancreatico-enteric fistula
References
Part IX Spleen and Lymphoproliferative Disease
Splenectomy for hematological disorders
Selman Uranüs, M.D. and Heinz Sill, M.D.
Introduction
Splenectomy
References
Laparoscopic splenectomy for benign and malignant hematologic diseases
Bertrand Millat, M.D. and Georges Decker, M.D.
Indications for LS
Operative techniques
Results of laparoscopic splenectomy
Conclusions
References
Lymphoma
Alan M Yahanda, M.D.
Epidemiology and pathology
Surgery in the diagnosis of lymphoma
Staging laparotomy in Hodgkin's disease
Splenectomy in Non-Hodgkin's lymphoma
Summary
References
Part X Endocrine
Differentiated thyroid carcinoma
O. Gimm and H. Dralle
Definition, epidemiology and pathogenesis
Diagnosis
Surgical treatment
Primary therapy
Non-surgical treatment modalities
Conclusion
References
Sporadic and hereditary medullary carcinoma
O. Gimm and H. Dralle
Definition, epidemiology and pathogenesis
Diagnosis
Non-surgical treatment modalities
Surgical treatment
Conclusion
Acknowledgement
References
Thyroid carcinosarcoma and undifferentiated thyroid carcinoma
S. Al-Sobhi and O. Clark
Carcinosarcoma
Anaplastic Carcinoma
Lymphoma of the Thyroid Gland
References
Benign nodular thyroid disease
René G Holzheimer, M.D.
Introduction
Definition, pathogenesis, and epidemiology
Diagnosis
Nontoxic uninodular thyroid disease
Nontoxic multinodular goiter
Toxic uninodular and multinodular goiter
Graves’ disease (M. Basedow)
Conclusion
References
Primary hyperparathyroidism
G Åkerstrom and E Lundgren
Definition, pathogenesis, and epidemiology
Symptoms
Diagnosis of HPT
Surgery
Non-operative surveillance
References
Parathyroid carcinoma
Kerstin Sandelin
Incidence
Diagnosis
Recurrent metastatic disease
Prognosis
Conclusion
References
Postoperative complications of parathyroidectomy
J. R Farndon
Infection
Hematoma
Skin tethering
Keloid formation
Hematoma
Recurrent nerve injury
Superior laryngeal nerve
Adenoma/disease not found
Persistent/recurrent disease
Wrong diagnosis/persistent disease
Hypocalcemia
Complications and informed consent
References
Laparoscopic adrenalectomy
Stephen E Burpee, M.D., Gregg H Jossart, M.D., and Michel Gagner, M.D.
Indications
Contraindications
Results
References
Surgical management of adrenal neoplasms: laparoscopic versus open adrenalectomy
Peter Y Wong, M.D. and Richard A Prinz, M.D.
Introduction
Conventional open methods for adrenalectomy
The flank or posterior approach
The anterior or transabdominal approach
The transthoracic or thoracoabdominal approach
The lateral transperitoneal or flank laparoscopic approach
The anterior laparoscopic approach
The posterior or retroperitoneal laparoscopic approach
Laparoscopic versus open adrenalectomy
References
Pheochromocytoma
Nader N Hanna, M.D. and Daniel E Kenady, M.D.
Definition, origin, and epidemiology
Extra-adrenal pheochromocytomas
Familial and hereditary pheochromocytomas
Pathophysiology and symptomatology
Biochemical diagnosis
Pharmacological tests
Localization
Pre-operative management
Surgical management
Surgical approaches
Anesthetic and intraoperative considerations
Surgical outcome and post-operative follow-up
Malignant pheochromocytomas
Pheochromocytoma in pregnancy
Conclusion
References
Endocrine tumors of the pancreas
François Pattou, M.D. and Charles Proye, M.D.
Introduction
Pathology
Symptom recognition
Confirm the diagnosis
Ruling out a genetic setting
Localization of the tumors
Treatment
Surgical strategy
Advanced disease
References
Gastrinoma
Robert T Jensen
Introduction, history and definition
Epidemiology
Clinical features ()
Diagnosis and differential diagnosis
Pathology, tumor biology and pathogenesis
Management
Prognosis
References
Neuroendocrine tumors metastatic to the liver
Ingemar Ihse, M.D., Gert Lindell, M.D., and Sten Tibblin, M.D.
Primary tumors and frequency of neuroendocrine liver metastases
Diagnosis
Surgical management
Ischemic therapy, embolization, chemoembolization
Medical therapy
Management of non-functioning pancreatic endocrine tumors
References
Small bowel neuroendocrine tumors
G. Åkerström and P. Hellman
Definition and incidence
Morphologic features
Clinical presentation
Diagnosis
Surgery of the mesenterico-intestinal lesion
Medical treatment
Treatment of liver metastases
Survival and life quality
References
Part XI Soft tissue tumors and melanoma
Soft tissue sarcoma
David C Linehan and Murray F Brennan
Introduction
Etiology, epidemiology and genetics
Pathology, clinical presentation and staging
Treatment of localized STS
Treatment of local recurrence
Surgical treatment of metastatic STS
Summary
Reference List
Malignant of melanoma
Paul L Baron and Christophe L Nguyen
Background
Microstaging
Conclusion
References
Isolated limb perfusion for malignant melanoma
Hiram C Polk Jr., M.D. and Michael J Edwards, M.D.
Introduction
Melanoma prognosis and therapy
Perfusion technique
Patient selection
Collective studies
Summary
References
Adjuvant therapy of malignant melanoma
Prof. Alexander M M Eggermont, M.D.
Adjuvant surgical procedures in the management of primary melanoma
Systemic adjuvant therapy
Adjuvant IFNα trials
Conclusions
References
Part XII Miscellaneous
Carcinoma of the lung
J. L Balibrea, A. J Torres, and J. Arias-Diaz
Risk factors
Pathology
Stage
Prevention
Non-small-cell lung cancer (NSCLC)
Small-cell lung cancer
References
Thoracoscopic pulmonary surgery
T. Hau and E. Förster
Trauma
Pleural empyema
Recurrent or persistant pneumothorax
Pulmonary resection
Thoracoscopy in cancer patients
Surgical treatment of pulmonary emphysema
References
Carcinoma of the breast
Gordon F Schwartz, M.D.
Introduction
Diagnosis
Staging
Treatment
In situ lobular carcinoma (LCIS)
In situ ductal carcinoma (DCIS)
Clinical stages I and II invasive carcinoma
Adjuvant therapy
Clinical stage III (A and B) invasive carcinoma
Post-mastectomy radiation therapy
Clinical stage IV carcinoma
Management of local recurrence following breast conservation
Male breast cancer
Follow-up of the breast cancer patient
References
Sentinel node detection
A. Bembenek, M.D. and P.M. Schlag, M.D.
Definition
Technique
Influence of particle size
Examination of the SN
SN in melanoma patients
Current technique of the SN-biopsy in melanoma
Clinical application
SN in breast cancer patients
Internal mammary lymph nodes
Clinical application
Further application of the SN-concept
Conclusion
References
Complications of laparoscopic surgery
Richard A Perugini, M.D. and Mark P Callery, M.D.
Complications of laparoscopic access
Physiologic complications of pneumoperitoneum
Complications of operative procedure
Conclusions
References
Intra-operative and laparoscopic ultrasound
Bruce David Schirmer, M.D.
Abstract
Equipment and technique
Summary
References
Part XIII Abdominal wall
Hernias
Joachim Conze, Uwe Klinge, and V. Schumpelick
Definition
History
Pathogenesis
Epidemiology
Diagnosis
Classification
Symptoms and Complications
Surgical Procedures
Inguinal Hernia in Adults
Inguinal Hernia in Children
Femoral Hernia
Epigastric Hernia
Umbilical Hernia
Spieghelian Hernia
Obturator Hernia
Perineal Hernia
Incisional or Recurrent Hernia
References
Management of the difficult abdominal closure
Anna M Ledgerwood, M.D.
Types of wound closures
Abdominal wall pack technique
Bilateral advancement muscle flap technique
References
Abdominal wall considerations in re-operative surgery
D. E Fry
Definitions, pathogenesis, and epidemiology
Diagnosis
Prevention
Management of abdominal wound complications
References
Part XIV Trauma
Liver trauma
Karen J Brasel, M.D. and Anthony A Meyer, M.D.
Settled controversy: management choice for blunt hepatic injury
Current controversies: role of angiography and management of penetrating injuries
References
Pancreatic, splenic and duodenal injuries
Ken Boffard and Adam Brooks
Introduction
Pancreatic injury
Duodenal injury
Complications
Summary
Splenic injury
Summary
References
Colon injuries
C. G Rehm and D. D Trunkey
Diagnosis
Management
Technique of exploration
Direct wound management options
Conclusion
References
Damage control
Jon M Burch, M.D. and Ernest E Moore, M.D.
Results
References
Part XV Surgical Infections
Soft tissue infections
R.T. Lewis
Introduction
Presentation and pathogenesis
Necrotizing focal infections
Toxic non-necrotizing focal infections
Diffuse non-necrotizing infection: cellulitis
Diffuse necrotizing cellulitis
Diagnosis
Treatment
References
Necrotizing soft-tissue infections
Thomas L Bosshardt, M.D., Vernon J Henderson, M.D, and Claude H Organ Jr, M.D.
Presentation and diagnosis
Bacteriology
Treatment
Mortality
Summary
References
Diabetic foot infections
Charles A Adams Jr., M.D. and Edwin A Deitch, M.D.
Definition, pathogenesis, and epidemiology
Diagnosis
Antibiotic therapy
Non-surgical treatments
Surgical treatment
Conclusion
References
Wounds in infection and sepsis - role of growth factors and mediators
David T Efron, M.D. and Adrian Barbul, M.D.
Phases of normal healing
Role of growth factors in normal healing
Impaired healing in sepsis
Surgical site infection
Current clinical strategies for growth factor therapy
Conclusion
References
Burn wound infections
LC Cancio, M.D., PA Howard, M.D., AT McManus, SH Kim, M.D., CW Goodwin, M.D., and BA Pruitt Jr., M.D.
Introduction
Invasive burn wound infection
Invasive infection of excised wounds, donor sites, and grafted wounds
Burn wound cellulitis
Burn wound impetigo
Conclusions
Acknowledgments
References
Current therapy of burns
Arthur P Sanford, M.D. and David N Herndon, M.D.
Conclusion
References
Management of secondary peritonitis
René G Holzheimer
Definition, pathogenesis, and epidemiology
Conclusion
References
Management of intra-abdominal abscesses
M. Schein
Definition and significance
Classification & pathogenesis
Microbiology
Clinical features
Diagnosis
Treatment
Conservative treatment
Drainage
Surgical management of intra-abdominal abscesses
Conclusions
References
The abdomen as a source of sepsis in critically ill patient
Ronald C Merrell, M.D. and Rifat Latifi, M.D.
Anatomy of intra-abdominal sepsis
Diagnostic approach to patient with expected abdominal sepsis
Patient with secondary dependent pathology
Patient with secondary independent pathology
Treatment options of intra-abdominal pathology in critically ill patients
Summary
References
Bloodstream and intravascular catheter infections
Kelli M Bullard, M.D. and David L Dunn, M.D.
Sepsis syndrome
Gram-negative bacteremia
Gram-positive bacteremia
Fungemia
Intravascular catheter infection
Summary
References
Antibiotic prophylaxis
René G Holzheimer
Epidemiology
Pathogenesis
Classification and Risk factors
Selection of antibiotics
Recommendation for specific procedures ()
References
Antibiotics in surgery: evidence of anecdote?
John M A Bohnen, M.D.
Conclusion
References
Part XVI Surgical critical care issues
Cardiopulmonary resuscitation
Robert K Goldman, M.D. and Donald Trunkey, M.D.
Definition, pathogenesis, and epidemiology
Diagnosis
Therapy
Conclusion
References
Hemodynamic monitoring
Christian Kuhn and Karl Werdan
Goals of monitoring
Physiological basis of cardiac monitoring
Contractility
Monitoring techniques
References
ARDS
Lothar Engelmann, M.D.
Definition
Pathogenesis
Epidemiology and prognosis
Diagnosis
Management
Conclusion
References
Catecholamines and acute renal failure
John A Kellum, M.D.
Introduction
Definitions, pathophysiology and epidemiology
Dopamine and related agents
Other catecholamines
Conclusions and recommendations
References
Hepatocellular dysfunction–basic considerations
Doraid Jarrar, M.D., Ping Wang, M.D., and Irshad H Chaudry, Ph.D.
Introduction
Alterations in hepatocellular function following trauma and hemorrhage
Summary
References
Monitoring of the hepatosplanchnic region
Karl Träger, Alexander Brinkmann, and Peter Radermacher
Introduction
Measurement of splanchnic blood flow, oxygen transport
Measurement of regional PCO
2
Measurement of hepatosplanchnic metabolism
Summary
References
Prophylaxis and management of stress ulceration
Avery B Nathens, M.D. and Ronald V Maier, M.D.
Epidemiology
Pathogenesis
Prophylaxis
Management
References
The multiple organ dysfunction syndrome
John C Marshall, M.D.
MODS: Clinical and pathologic description
Prevention of MODS
Conclusion
References
The immunocompromised patient
Philip S Barie, M.D.
Adrenal insufficiency
Diabetes mellitus
Febrile neutropenia
Human immunodeficiency virus infection
References
Laparotomy for abdominal sepsis in the critically ill
Christian H Wakefield and Kenneth C H Fearon
Introduction
Demographics of intra-abdominal sepsis
Surgical approaches and treatment goals
Expectations of re-laparotomy
Conclusion
References
Abdominal compartment syndrome
Bob H Saggi, M.D., Rao Ivatury, M.D., and Harvey J Sugerman, M.D.
Introduction
Historical background
Recognition of ACS
Pathophysiology
Clinical management
Summary
References
Analgesia and sedation in critically ill patients
Daniel R Brown, M.D. and Michael J Murray, M.D.
Introduction
Analgesia
Sedation
Summary
References
Assessment of coagulation in surgical critical care patients
Ian D McGilvray, M.D. and Ori D Rotstein, M.D.
Abstract
Introduction
The coagulation cascade
Counter-regulation of coagulation
Contribution of the coagulation cascade to the local and systemic inflammatory response
The surgical critically ill patient: a procoagulant condition
Diagnostic tests of coagulation
Coagulation issues in critical care patients
Overview: Assessment of coagulation in the critically ill surgical patient
Conclusions
References
Methicillin-resistant staphylococcus aureus
M. S Ibelings and H. A Bruining
Candida infections in surgical intensive care unit patients
Jean-Louis Vincent
Introduction
Epidemiology and pathogenesis
Diagnosis
Therapy
Conclusion
References
Ethical considerations
WI Karen J Brasel, M.D.H. and Anthony A Meyer, M.D.
Does the presence or type of hospital DNR policy influence DNR orders or discussions about limiting care in any way?
Does the presence of a DNR order influence resource use or nursing care?
Can education change physician practices regarding end of life decisions?
Do patients want to discuss DNR preferences?
References
Nitric oxide in trauma and sepsis
C. Hierholzer and T. R Billiar
Summary
NO production
Molecular targets
Cytoprotection, cytotoxicity
Hemorrhagic shock
Sepsis
Therapeutic interventions
Conclusions
References
Appendix
Copyright © 2001
W. Zuckschwerdt Verlag GmbH
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