Book Reviews / Critiques de livres
Canadian Journal of Surgery 1997;40(4):316
ADVANCES IN SURGERY. Volume 30. Editor-in-Chief: John L. Cameron. 463 pp. Illust. MosbyYear Book, Inc., St. Louis. 1996. Can$102. ISBN 0-8151-1496-6
The Advances in Surgery series reviews a variety of important, current, controversial topics. In this volume, general and vascular surgeons will find subjects of interest, but there are also chapters on colorectal, plastic, neuro-, thoracic, oncologic and endocrine surgery.
Three papers cover carcinoma of the pancreas or bile duct. There is a good review of preoperative staging for carcinoma of the pancreas from the Massachusetts General Hospital. Newer investigations include spinal CT, magnetic resonance imaging, angiography and laparoscopy. Yeo and colleagues from Johns Hopkins Hospital review alternatives to the Whipple procedure. They conclude that the extended operation offers no benefit over the standard Whipple procedure. Cameron, the editor, is one of the authors to review perihilar cholangiocarcinoma: aggressive surgery provides the only potential cure, but the prognosis is still poor. Palliative and adjuvant therapies are discussed.
Other chapters review topics in oncology. Singletary and colleagues from the M.D. Anderson Cancer Center review skin-sparing mastectomy and immediate reconstruction with the use of a conventional or free transverse rectus abdominis musculocutaneous flap. A separate chapter reviews the use of the sentinel lymph node for the management of breast cancer; there is a definite learning curve associated with the use of this technique. Cryotherapy for liver tumours is reviewed briefly. There is an excellent chapter on the rare but challenging problem of pseudomyxoma peritonei. Sugarbaker and 18 colleagues from the Washington Cancer Institute give a complete and careful review including cytoreductive surgery.
Several contributions will interest vascular surgeons. Perlor reviews ruptured abdominal aortic aneurysms. A group from Albany, NY, reports good long-term results for in-situ saphenous vein grafts. There is a chapter on the continuing challenges presented by the diabetic foot and another on the more rare but difficult problems presented by the Raynaud syndrome. A short review of vascular access for hemodialysis includes radiologic thrombectomy, angioplasty and urokinase infusion for graft stenosis or occlusion.
Reviews of physiology cover both ends of the gastrointestinal tract. DeMeester provides a good review of esophageal motor abnormalities and a chapter on stress ulceration, including controversies in prophylaxis with changes in bacterial flora and the potential for pneumonia. Another review covers the important field of enteric feeding. The difficult problem of anorectal incontinence is reviewed by a group from the Mayo Clinic.
Two chapters will interest thoracic surgeons: one on mediastinal tumours and another on the surgical treatment of emphysema with up-to-date references.
In a short review on the surgical treatment of hyperparathyroidism, localization is said not to be needed or to be cost-effective unless the patient has undergone previous surgery. Some surgeons would disagree with this statement.
Three additional chapters review burns and trauma. Advances in the treatment of burns are covered by a review from the Shriner's Institute in Texas. Trunkey and colleagues describe some of the basic mechanisms involved in the use of steroids for head injury. Another chapter reviews the nonoperative treatment of liver and splenic injury.
Surgeons in all specialties except urology will find topics of interest in this book, but because of the wide range of material covered the book is more suitable for institution libraries than individual libraries.
D. Michael Grace, MD
Department of Surgery
London Health Sciences Centre
University of Western Ontario
London, Ont.
© 1997 Canadian Medical Association
THE CRITICALLY ILL CARDIAC PATIENT -- MULTISYSTEM DYSFUNCTION AND MANAGEMENT. Edited by Vladimir Kvetan and David R. Dantzker. 432 pp. Illust. LippincottRaven Publishers, Philadelphia. 1996. US$125. ISBN 0-397-51465-4
Overall rating: Excellent
Strengths: Current and well referenced. Draws attention to the "complete patient" who has heart disease
Weaknesses: Modesty in its intended readership
Audience: Physicians who deliver critical care to patients with heart disease
This text is a clinical, collaborative, state-of-the-art review of the multisystem management of patients with heart disease by a diverse team of academic contributors. Although intended as a curriculum of critical care medicine for cardiologists, it is clearly applicable to any physician caring for cardiac patients in the critical care or the perioperative setting. It complements other basic critical care textbooks, and some background in cardiac, circulatory and respiratory physiology, and pharmacologic management of the cardiac patient is necessary. All major organ systems are reviewed.
The initial chapter deals primarily with diagnostic modalities for coronary artery disease, aging and nutrition, and may give an impression that the contents are limited to a cardiology only perspective, but a comprehensive multisystem review follows.
The high-risk cardiac patient for noncardiac surgery is well described, and clear recommendations are made on coronary artery disease, but there is limited discussion on congenital heart disease and the impact of anesthesia.
Sections on ventilator support and heartlung interactions in heart failure and oxygen transport and utilization are excellent. The multisystem approach to the critically ill patient is apparent in the detailed chapters on regional circulation, renal function and neurologic disorders, which are tailored to the patient with heart failure. The frustration of abdominal crises in the critical care setting is made less intimidating. Recent developments in the understanding of septic shock and the nature of resultant myocardial depression is concisely presented. The pharmacology of cardiac support and management of common cardiac drug toxicities are not presented as recipe-type approaches but rather as an understanding of the "how and why" of these issues. Most clinical aspects of hematology and coagulation in cardiac patients are addressed, including a thorough description of platelet and endothelial function. Cardiorespiratory changes in normal pregnancy and most cardiac conditions that one can expect to see in the obstetrical patient are addressed, a chapter valuable to those with limited exposure to obstetrical care. Cardiac trauma is concisely
reviewed and the section on cardiovascular complications of organ transplantation is a timely review for the critical care physician.
An excellent section on transesophageal echocardiography in the intensive care unit and a brief review of basic respiratory mechanics are included, and transportation, pulmonary artery catheters, intra-aortic balloons and basic transvenous pacing are "introduced." A section on thoracic radiology is representative and is generously illustrated. Post-myocardial infarction risk stratification and the difficulties in using standard intensive care unit severity scores in the cardiac patient are addressed.
This text is valuable for any physician who cares for inhospital cardiac patients.
Michael E. Bourke, MD
Assistant Professor of Anesthesia.
Medical Director
Cardiac Surgical Critical Care
University of Ottawa Heart Institute
Ottawa, Ont.
© 1997 Canadian Medical Association
ENDOVASCULAR SURGERY FOR AORTIC ANEURYSMS. Brian Hopkinson, Waquar Yusuf, Simon Whitaker and Frank Veith. 310 pp. Illust. W.B. Saunders Company Ltd., London. 1997. Can$117. ISBN 0-7020-2148-2
Endovascular treatment of aortic aneurysms was first described by Parodi in 1991. Since then, many devices have been deployed, most constructed from already existing materials. This textbook attempts to report on the current status of this evolving technique. Thirty-five contributing authors relate their experience with respect to endovascular grafting.
The early chapters, designed as an introduction, outline optimal preoperative and intraoperative imaging techniques. Of particular strength is the chapter by Ivancev and Chuter on adjunctive manoeuvres for endovascular exclusion of abdominal aortic aneurysms, in which they discuss common difficulties encountered and provide useful solutions on how to deal with the difficult anatomy seen on preoperative imaging.
The major portion of the book reviews the experience of the various endovascular systems. These include the MinTec system, ChuterGianturco bifurcated stent-grafts, EndoVascular Technologies, Corvita system, IvanceMalmo system and Parodi system. In addition, the Australian experience with a variety of endovascular grafts is reviewed. All authors have attempted to describe the procedure for endoluminal grafting in detail. Overall, 515 procedures are reviewed by 10 different institutions, the smallest series comprising 14 patients and the largest 88. The final chapters review the mechanisms of renal injury, ischemicreperfusion injury and colonic perfusion as well as anesthetic implications for open and endovascular procedures.
The authors should be commended for the difficult task of writing a textbook on a topic that is in its infancy and evolving rapidly. One distraction is the repetitive description of each device by the various authors. Since none of these are currently approved for widespread use, a more concise description would have made reading easier. The problems encountered during placement of the devices and techniques used to avoid and solve these problems are an asset for anyone considering entering the field of endovascular graft surgery.
Daniel I. Obrand, MD
Assistant Professor of Surgery
Division of Vascular Surgery
Sir Mortimer B. Davis-Jewish General Hospital
McGill University
Montreal, Que.
© 1997 Canadian Medical Association
