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ویرایش: 21
نویسندگان: Courtney M. Townsend Jr. JR MD (editor)
سری:
ISBN (شابک) : 0323640621, 9780323640626
ناشر: Elsevier
سال نشر: 2021
تعداد صفحات: 2197
زبان: English
فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود)
حجم فایل: 143 مگابایت
در صورت تبدیل فایل کتاب Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice به فرمت های PDF، EPUB، AZW3، MOBI و یا DJVU می توانید به پشتیبان اطلاع دهید تا فایل مورد نظر را تبدیل نمایند.
توجه داشته باشید کتاب کتاب درسی جراحی سابیستون: مبنای بیولوژیکی عمل جراحی مدرن نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
Front Cover IFC IFC SABISTON TEXTBOOK of SURGERY The BIOLOGICAL BASIS Copyright Dedication CONTRIBUTORS PREFACE FOREWORD ACKNOWLEDGMENTS CONTENTS VIDEO CONTENTS I - Surgical Basis Principles 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 X-Rays Blood Transfusion Frozen Section ASCENT OF SCIENTIFIC SURGERY Standardized Postgraduate Surgical Education and Training Programs Experimental Surgical Research Laboratories Specialty Journals, Textbooks, Monographs, and Treatises Professional Societies and Licensing Organizations THE MODERN ERA DIVERSITY THE FUTURE SELECTED REFERENCES 2 - Ethics and Professionalism in Surgery ETHICAL FRAMEWORKS PHYSICIAN–PATIENT RELATIONSHIP SURGICAL TRAINING AND INNOVATION CONCLUSION SELECTED REFERENCES REFERENCES 3 - The Inflammatory Response COMPONENTS OF THE INFLAMMATORY RESPONSE Cells of the Immune System Neutrophils Macrophages Dendritic Cells T Cell B Cell Innate Immunity Toll-Like Receptors Inflammasome High-Mobility Group Box Protein 1 Cytokines Complement System Adaptive Immunity The Nervous System and Immunity The Inflammatory Reflex Arc The Neuroendocrine System and Inflammation INFLAMMATION AND THE CRITICALLY ILL Historical Perspective Systemic Inflammatory Response Syndrome Compensatory Antiinflammatory Response Genomics and Understanding Inflammation Diagnosis and Immunotherapy in Sepsis Multiple Organ Failure Persistent Inflammation, Immunosuppression, and Catabolism Syndrome SELECTED REFERENCES REFERENCES 4 - Shock, Electrolytes, and Fluid HISTORY Resuscitation Shock Fluids Blood Transfusions Bleeding Shock Index Lactate and Base Deficit Compensatory Mechanisms Lethal Triad Acidosis Hypothermia Coagulopathy Oxygen Delivery Optimization (Supernormalization) Global Perfusion Versus Regional Perfusion Septic Shock Bleeding Trauma Immunology and Inflammation Detrimental Impact of Fluids Damage Control Resuscitation Whole Blood Resuscitation Resuscitation With 1:1:1 Massive Transfusion Protocol Crystalloids Hypertonic Saline Colloids Blood Substitutes Perfluorocarbons Novel Fluids Dried Plasma Pharmacologic Agents Suspended Animation Body Water Maintenance Fluids Adrenal Gland Antidiuretic Hormone and Water Sodium Hyponatremia Hypernatremia Potassium Hypokalemia Hyperkalemia Calcium Hypocalcemia Hypercalcemia Magnesium Hypomagnesemia Hypermagnesemia SELECTED REFERENCES REFERENCES 5 - Metabolism in Surgical Patients METABOLIC SCIENCE History of Metabolism Research Cellular Bioenergetics Maintenance of Cell Structure and Function SURGICAL METABOLISM Assessment of Nutritional Status Metabolism in Critical Illness Inflammatory Diseases Without Hypermetabolism Inflammatory Diseases With Hypermetabolism CONCLUSION SELECTED REFERENCES REFERENCES 6 - Wound Healing WOUND-HEALING PHASES Inflammatory Phase Hemostasis and Inflammation Increased Vascular Permeability Chemokines Polymorphonuclear Cells Macrophages Lymphocytes Proliferative Phase Angiogenesis Fibroplasia Epithelialization Extracellular Matrix Maturational Phase Remodeling ABNORMAL WOUND HEALING Hypertrophic Scars and Keloids Prevention of Hypertrophic or Keloid Scars Linear Hypertrophic Scars Widespread Hypertrophic Scars Keloids Chronic Nonhealing Wounds Other Causes of Abnormal Wound Healing Hypoxia Diabetes Ionizing Radiation Aging Malnutrition Drugs Treatment of Chronic Wounds WOUND DRESSINGS OTHER THERAPIES Hyperbaric Oxygen Therapy Negative Pressure–Assisted Wound Therapy FETAL WOUND HEALING TISSUE ENGINEERING GENE AND STEM CELL THERAPY NEW HORIZONS SELECTED REFERENCES REFERENCES 7 - Regenerative Medicine STEM CELL SOURCES Embryonic Stem Cells Somatic Cell Nuclear Transfer Induced Pluripotent Stem Cells Fetal Stem Cells Adult Stem Cells Hematopoietic Stem Cells Mesenchymal Stem/Stromal Cells Bone Marrow–Derived Stromal Cells Adipose Tissue–Derived Stem/Stromal Cells Endothelial Progenitor Cells Skeletal Stem Cells Miscellaneous Adult Stem Cells Stem Cells and Cancer BIOENGINEERING FOR REGENERATIVE MEDICINE Biomaterials as Constructs for Cell Delivery and Cell Differentiation Organ-Level Tissue Engineering CLINICAL APPLICATIONS OF STEM CELLS Embryonic Stem Cells Somatic Cell Nuclear Transfer Induced Pluripotent Stem Cells Bone Marrow Transplant Multipotent Adult Stem Cells CONCLUSION SELECTED REFERENCES REFERENCES 8 - Critical Assessment of Surgical Outcomes and Health Services Research EVIDENCE-BASED APPROACH TO SURGERY Evaluating Research Study Questions Study Design Randomized Controlled Trials Cross-Sectional Study Case-Control Study Cohort Study Case Series and Reports Synthetic and Systematic Outcome Studies Meta Analyses Cost-Effectiveness Analysis Systematic Reviews Qualitative Data Analysis APPRAISING SURGICAL EVIDENCE Evaluating Study Quality Internal Validity Hypothesis Testing INTERPRETING AND APPLYING EVIDENCE TO SURGICAL PRACTICE CONCLUSION SELECTED REFERENCES REFERENCES 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 SELECTED REFERENCES REFERENCES II - Perioperative Management 10 - Principles of Preoperative and Operative Surgery Principles of Surgical Evaluation Patient–Surgeon Relationship Surgical Objectives Elective, Urgent, and Emergent Indications Risk Assessment Informed Consent Assessment of Geriatric Surgical Patients Comprehensive Geriatric Assessment Cognitive Impairment and Delirium Depression Medication Management Functional Status and Frailty Patient Counseling Systems Approach to Preoperative Evaluation Cardiovascular System Risk Prediction Scales/Indices Preoperative Testing (Electrocardiogram, Echocardiography, Stress Test, Angiography) Surgery After Coronary Revascularization Other High-Risk Cardiac Patients Perioperative Cardiovascular Medications Pulmonary System Renal System Hepatobiliary System Hematologic System Anemia Inherited Coagulopathy Antiplatelet Therapies Anticoagulation Oral Direct Thrombin and Factor Xa Inhibitors Endocrine System Diabetes Mellitus Hyperthyroidism and Hypothyroidism Adrenocortical System Neoplastic Endocrinopathies Nutrition and Obesity Preoperative Nutrition Assessment Nutrition Supplementation Obesity Patient Recovery Pathways Antibiotic Prophylaxis Review of Medications Preoperative Fasting Operating Room Maintenance of Normothermia Preoperative Skin Preparation Hemostasis Wound Closure Surgical Adhesives Electrosurgery and Electrocautery Monopolar Electrosurgery Bipolar Electrosurgery LigaSure and Enseal Saline-Cooled Radiofrequency Dissectors Ultrasonic Dissectors Harmonic Scalpel Cavitron Ultrasound Surgical Aspirator Ablation Technology Radiofrequency Ablation Microwave Ablation Other Energy Devices Argon Beam Coagulator Surgical Staplers Malignant Hyperthermia Gas Embolus: Air and Carbon Dioxide Myocardial Infarction, Pulmonary Embolus, and Pneumothorax Hemorrhage Outpatient Surgery Selected References References 11 - Surgical Infections and Antibiotic Use SURGICAL SITE INFECTIONS Classification of Surgical Site Infection Risk Factors for Surgical Site Infection Surgical Site Infection Prevention NECROTIZING SOFT TISSUE INFECTIONS Diagnosis Imaging Local Exploration Treatment of Necrotizing Soft Tissue Infections Surgery Antibiotics Resuscitation Wound Care and Reconstruction SPECIFIC INFECTIONS Intraabdominal Abscess Definition, Etiology, and Classification of Intraabdominal Abscess Diagnostic Evaluation Intrathoracic Abscess Management of Pleural Empyema Clostridium difficile Infection Clostridium septicum and Colorectal Malignancy HEALTH CARE–ASSOCIATED INFECTIONS Catheter-Associated Bloodstream Infections Catheter-Associated Urinary Tract Infections Ventilator-Associated Pneumonia ANTIBIOTIC RESISTANCE CLINICALLY IMPORTANT PATHOGENS Carbapenem-Resistant Enterobacteriaceae Mode of Transmission Reservoirs Risk Factors for Carbapenem-Resistant Enterobacteriaceae Infections Treatment Vancomycin-Resistant Enterococcus Mode of Transmission VRE Reservoirs Risk Factors for VRE Infection Treatment Fungal Infections in Surgical Patients Mode of Transmission Risk Factors Diagnosis Treatment of Invasive Fungal Infections SELECTED REFERENCES REFERENCES 12 - Surgical Complications Wound Complications Seroma Hematoma Presentation and Management Acute Wound Failure (Dehiscence) Causes Presentation and Management Surgical Site Infection Prevention and Management Thermal Regulation Hypothermia Causes Presentation Treatment Malignant Hyperthermia Postoperative Fever Causes Respiratory Complications General Considerations Atelectasis Pneumonia Diagnosis Treatment Aspiration Pneumonitis and Aspiration Pneumonia Causes Presentation and Diagnosis Treatment Pulmonary Edema and Acute Respiratory Distress Syndrome Presentation and Diagnosis Management Venous Thromboembolism Presentation and Diagnosis Management Cardiac Complications Perioperative Myocardial Ischemia and Infarction Cause Presentation and Diagnosis Prevention and Management Postoperative Hypertension Causes Presentation and Management Postoperative Arrhythmias Presentation Postoperative Heart Failure Presentation and Management Renal and Urinary Complications Acute Kidney Injury Urinary Retention29 Presentation and Management Endocrine Dysfunction Adrenal Insufficiency Causes Presentation Management Hyperthyroid Crisis Causes Presentation and Diagnosis Treatment Hypothyroidism Causes Presentation and Diagnosis Treatment Syndrome of Inappropriate Antidiuretic Hormone Secretion Causes Presentation Treatment Gastrointestinal Complications Ileus and Early Postoperative Bowel Obstruction Causes Presentation Treatment Abdominal Compartment Syndrome Cause Presentation Diagnosis Treatment Postoperative Gastrointestinal Bleeding Causes Presentation Diagnosis and Treatment Stomal Complications Causes Presentation and Diagnosis Treatment Clostridioides difficile Colitis Clinical Presentation Diagnosis Prevention and Management Anastomotic Leak Causes Presentation and Diagnosis Intestinal Fistulas Causes Presentation and Diagnosis Treatment Pancreatic Fistulas Hepatobiliary Complications Bile Duct Injuries Causes Presentation and Diagnosis Treatment Vasculobiliary Injury Neurologic Complications Postoperative Delirium Cause and Risk Factors Presentation Prevention and Management Perioperative Seizure Perioperative Stroke Causes and Presentation Treatment Ear, Nose, and Throat Complications Epistaxis Nosocomial Sinusitis Acute Hearing Loss Parotitis The Geriatric Patient and Frailty Treatment Recommendations Selected References References 13 - Surgery in the Geriatric Patient Outcomes of Surgery in Older Adults Frailty and Physiologic Decline Frailty Organ-Specific Decline Cardiovascular System Respiratory System Renal System Hepatobiliary System Immune Function Glucose Homeostasis Patient Counseling Surgical Decision-Making Advanced Directives Palliative Care Screening to Identify High-Risk Characteristics Cognitive Assessment Capacity Delirium Risk Depression Functional Assessment Mobility/Fall Risk Assessment Nutritional Status and Swallowing Function Medication Management Multimodality Pain Control Delirium Aspiration Deconditioning Transitions of Care Surgery of Major Organ Systems Endocrine Surgery Thyroid Disease Parathyroid Disease Breast Disease Epidemiology Presentation and Screening Pathology and Treatment Gastrointestinal Surgery Esophagus Stomach Biliary Tract Disease Liver Small Bowel Obstruction Appendicitis Carcinoma of the Colon and Rectum Abdominal Wall Hernias Vascular Diseases Abdominal Aortic Aneurysm Carotid Artery Disease Peripheral Vascular Disease Cardiothoracic Diseases Coronary Artery Disease Valvular Disease Lung Cancer Trauma Transplantation Selected References References 14 - Anesthesiology Principles, Pain Management, and Conscious Sedation Pharmacologic Principles Inhalational Agents Nitrous Oxide Isoflurane Sevoflurane Desflurane Intravenous Agents Induction Agents Opioids Neuromuscular Blockers Anesthesia Equipment Blood Pressure Monitoring Electrocardiography Ventilation Monitoring Oxygenation Monitoring Temperature Monitoring Neuromuscular Blockade Monitoring Central Nervous System Monitoring Hemodynamic Monitoring (Transesophageal Echocardiography/Right Heart Catheter) Point-of-Care Ultrasound Preoperative Evaluation Airway Examination Cardiovascular Disease Endocarditis Prophylaxis Pulmonary Disease Renal and Hepatic Disease Nutrition, Endocrinology, and Metabolism Fasting Before Surgery Assessment of Physical Status Risk of Anesthesia Selection of a Specific Technique Airway Management General Anesthesia Regional Anesthesia Local Anesthetic Drugs Spinal Anesthesia Epidural Anesthesia Peripheral Nerve Blocks Abdominal Wall Blocks Enhanced Recovery After Surgery Pathways Conscious Sedation Postanesthesia Care Postoperative Agitation, Delirium, and Cognitive Decline Respiratory Complications Postoperative Nausea and Vomiting Hypothermia Circulatory Complications Postoperative Visual Loss Acute Pain Management Mechanisms of Acute Pain Methods of Analgesia Opioids Nonsteroidal Anti-inflammatory Drugs Local Anesthetics for the Management of Acute Pain Combination Analgesic Therapy Neuraxial Analgesia Intravenous Patient-Controlled Analgesia Selection of Methods of Postoperative Analgesia Chronic Pain Specific Types of Acute Pain Patients Patients With a History of Chronic Pain Patients With a History of Substance Abuse Pediatric Patients Elderly Patients Conclusion Selected References References 15 - Emerging Technology in Surgery: Informatics, Electronics Recent Significant Advances in Surgical Technology Continuing Evolution of Minimal-Access Surgery Advances in Endoscopy as a Surgical Platform Evolution of Minimally Invasive Robotic Surgery Digitization and Augmentation of Surgery Evolving Technologies in Surgery 3D Printing and Bioprinting Artificial Intelligence Intraoperative Diagnostic Tools for Targeted Surgery Process of Innovation in Surgery Conclusion Selected References References 16 - Robotic Surgery Preface History Preparing for Robotic Surgery Understanding da Vinci Si and Xi Surgical Systems Operating Room Setup Choosing Robotic Instruments Current Status of Selected Robotic Operations Robotic Ventral Hernia Repair With Mesh Robotic Total Mesorectal Excision for Rectal Cancer Robotic Pancreatic Surgery Robotic Pancreaticoduodenectomy Robotic Distal Pancreatectomy Robotic Liver Resections Robotic Versus Laparoscopic Liver Resections Difference in Lesion Location Conclusion Selected References References III - Trauma and Critical Care 17 - Management of Acute Trauma Overview and History Trauma Systems Injury Scoring Prehospital Trauma Care Initial Assessment and Management Airway Breathing Circulation Disability and Exposure Resuscitative Thoracotomy and Endovascular Aortic Occlusion Secondary Survey Management of Specific Injuries Damage Control Principles Injuries to the Brain Immediate Management Evaluation Management Injuries to the Spinal Cord and the Vertebral Column Immediate Management Evaluation Management Injury to the Maxillofacial Region Immediate Management Evaluation Management Injuries to the Neck Immediate Management Evaluation Management Injuries to the Chest Immediate Management Evaluation Management Injuries to the Abdomen Blunt Abdominal Trauma Evaluation Penetrating Abdominal Trauma Evaluation Management Injuries to the Pelvis and Extremities Rehabilitation Selected References References 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 Perioperative Considerations Summary Selected References References 19 - Emergency Care of Musculoskeletal Injuries Epidemiology of Orthopedic Injuries Terminology Fracture Types Other Injuries Fixation Principles Patient Evaluation History Trauma Room Evaluation Diagnostic Imaging Shoulder Elbow Forearm and Wrist Pelvis and Acetabulum Hip Knee Ankle Foot Spine Vascular Injuries Initial Management Wound Management Reduction and Immobilization Traction Prioritization of Surgical Care Time-Dependent Orthopedic Injuries Open Fractures Classification Initial Management Limb Salvage Versus Primary Amputation Fractures Secondary to Firearm Injury Skeletal Stabilization Acute Compartment Syndrome Pathogenesis Diagnosis Surgical Treatment Pelvic Ring Disruption Classification Management Initial Stabilization Definitive Management Spinal Injuries Evaluation Management Dislocations A dislocated joint is considered an orthopedic emergency because of the possibility of neurovascular injury and damage to the ar... Patient Evaluation Special Considerations for the Trauma Setting Treatment Vascular Injuries Incidence and Recognition Management Common Long Bone Fractures Femur Fractures Epidemiology and Significance Initial Management Definitive Stabilization Tibial Shaft Fractures Epidemiology and Significance Blood Supply Associated Soft Tissue Injuries Management and Treatment Humerus Shaft Fractures Epidemiology, Acceptable Alignment, and Associated Injuries Treatment Challenges and Complications Missed Injuries Drug and Alcohol Use Thromboembolic Complications Pulmonary Failure: Fat Emboli Syndrome and ARDS Postoperative Mobilization Summary Selected References References 20 - Burns General Considerations Burn Units Pathophysiology of Burns Local Changes Burn Depth Burn Size Systemic Changes Inflammation and Edema Effects on the Renal System Effects on the Immune System Hypermetabolism Initial Treatment of Burns Prehospital Initial Assessment Wound Care Transport Resuscitation Escharotomies Inhalation Injury Wound Care Antimicrobials Synthetic and Biologic Dressings Excision and Grafting Minimizing Complications Etiology and Pathophysiology Prevention Organ Failure Renal Failure Pulmonary Failure Hepatic Failure Hematologic Failure Nutrition Electrical Burns Initial Treatment Delayed Effects Chemical Burns Alkali Acids Hydrocarbons Summary Selected References References 21 - Bites and Stings SNAKEBITES Epidemiology Venomous Species Indigenous to United States Pathophysiology Clinical Manifestations Management Antivenin Therapy Coagulopathy of Envenomation Fasciotomy MAMMALIAN BITES Epidemiology Treatment Evaluation Wound Care Microbiology Antibiotics Rabies ARTHROPOD BITES AND STINGS Black Widow Spiders Toxicology Clinical Manifestations Treatment Brown Recluse Spiders Toxicology Clinical Manifestations Treatment Scorpions Toxicology Clinical Manifestations Treatment Ticks Hymenoptera Toxicology Clinical Reactions Treatment MARINE BITES AND STINGS Initial Assessment Microbiology of Marine-Related Soft Tissue Infections General Management Wound Care Antivenom Injuries From Nonvenomous Aquatic Animals Sharks Moray Eels Alligators and Crocodiles Miscellaneous Envenomation by Invertebrates Coelenterates Sponges Echinodermata Mollusks Annelid Worms (Bristleworms) Envenomation by Vertebrates Stingrays Miscellaneous Fish Sea Snakes SELECTED REFERENCES REFERENCES 22 - Surgical Critical Care NEUROLOGIC SYSTEM Pain and Agitation Altered Mental Status and Delirium CARDIOVASCULAR SYSTEM Cardiac Physiology Cardiac Arrhythmias Supraventricular Tachycardias Bradycardia Shock Hypovolemic Shock Hemorrhagic Shock Cardiogenic Shock Obstructive Shock Myocardial Infarction RESPIRATORY SYSTEM Respiratory Physiology Oxygen Therapy Noninvasive Ventilation Intubation and Mechanical Ventilation Standard Modes of Mechanical Ventilation Volume Assist Control Synchronized Intermittent Mandatory Ventilation Pressure Support Ventilation Advanced Modes of Mechanical Ventilation High-Frequency Oscillatory Ventilation Airway Pressure Release Ventilation and Biphasic Positive Airway Pressure Ventilation Pressure Regulated Volume Control and Adaptive Support Ventilation Extracorporeal Membrane Oxygenation Extubation or Tracheostomy Pulmonary Pathology Pulmonary Embolism Pneumonia Acute Respiratory Distress Syndrome GASTROINTESTINAL SYSTEM Nutritional Requirements of the Critically Ill Patient Enteral and Parenteral Nutrition Stress Ulcer Prophylaxis HEPATIC SYSTEM Perioperative Management of the Cirrhotic Patient Management of Liver Injuries RENAL SYSTEM Physiology Acid Base Disturbances Metabolic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis Electrolyte Abnormalities Hyponatremia Hypernatremia Acute Kidney Injury Hyperkalemia Volume Overload Metabolic Acidosis Hypocalcemia and Hyperphosphatemia HEMATOLOGIC SYSTEM Thromboelastography Heparin-Induced Thrombocytopenia Venous Thromboembolism Hemoglobin Transfusion Strategies ENDOCRINE SYSTEM Glucose Control Adrenal Insufficiency Thyroid Dysfunction INFECTIOUS DISEASES General Principles Central Line–Associated Bloodstream Infections Catheter-Associated Urinary Tract Infections Diarrhea and Clostridioides difficile Other Common Infectious Issues in the ICU Intra abdominal Infections Thrombophlebitis SPECIAL ISSUES The Open Abdomen Palliative Care Multisystem Organ Failure and Futility SELECTED REFERENCES REFERENCES 23 - Bedside Surgical Procedures RATIONALE FOR BEDSIDE SURGICAL PROCEDURES TAKING THE OPERATING ROOM TO THE BEDSIDE BEDSIDE LAPAROTOMY TRACHEOSTOMY PERCUTANEOUS ENDOSCOPIC GASTROSTOMY BRONCHOSCOPY SELECTED REFERENCES REFERENCES 24 - The Surgeon’s Role in Mass Casualty Incidents History Key Definitions Mascal Key Principles Critical Mascal Lessons Learned Training Triage Systems Readiness Understanding the Hospital Incident Command System Integration of Systems Security Communications Regional Local Integration Documentation and Patient Tracking Community Elements and Other Considerations Adaptable Grow (Elements of a Learning Health System) Exsanguination Control Along the Spectrum Conclusions Selected References References IV - Transplantation andImmunology 25 - Transplantation Immunobiology and Immunosuppression The Immune Response Innate Immunity Monocytes Dendritic Cells Natural Killer Cells Acquired Immunity Major Histocompatibility Locus: Transplant Antigens Human Histocompatibility Complex Class I Major Histocompatibility Complex Class II Major Histocompatibility Complex Human Leukocyte Antigen Typing: Implications for Transplantation Cellular Components of the Acquired Immune System T-Cell Receptor T-Cell Activation Costimulation T-Cell Effector Functions Cytokines B Cells and Antibody Production Transplant Immunity Rejection Hyperacute Rejection Acute Rejection Chronic Rejection Immunosuppression Induction Therapy Antithymocyte Globulin Anti–IL-2 Receptor Antibodies OKT3 Alemtuzumab Maintenance Immunosuppression Corticosteroids Antiplasma Cell Therapies Novel Immunosuppressive Agents Complications of Immunosuppression Risk of Infection Risk for Malignant Disease Nonimmune Side Effects Tolerance Lymphocyte Depletion Costimulation Blockade Chimerism Xenotransplantation Concordant Xenografts Discordant Xenografts New Areas of Transplantation Islet Cell Transplantation Vascularized Composite Tissue Transplantation Uterus Transplantation Conclusion Selected References References 26 - Liver Transplantation History Indications Noncholestatic Cirrhosis Alcoholic Nonalcoholic Fatty Liver Disease Hepatitis C Cryptogenic Autoimmune Hepatitis B Cholestatic Liver Disease Primary Biliary Cholangitis Primary Sclerosing Cholangitis Caroli Disease Acute Liver Failure Malignant Neoplasms Hepatocellular Cancer Cholangiocarcinoma Other Budd-Chiari Syndrome Very Rare Causes of Liver Failure That Can Be Addressed With Liver Transplantation Total Parenteral Nutrition/Hyperalimentation-Induced Liver Disease Polycystic Liver Disease Hepatic Adenoma Metastatic Cancer Hemangioendothelioma Wilson Disease Contraindications Meld and Allocation Donor Selection Preoperative Evaluation Surgical Considerations Postoperative Management Complications and Their Treatment Immunosuppression Donor Recipient Pediatric Liver Transplantation Selected References References 27 - Kidney and Pancreas Transplantation HISTORICAL PERSPECTIVE Kidney Transplantation Indications Patient Selection Living Donor Selection Laparoscopic Surgical Technique Open Surgical Technique Postoperative Care and Follow-up of Living Donors Deceased Donor Surgical Technique Preservation and Storage Recipient Operation Kidney Allocation Postoperative Surgical Complications Hemorrhage Venous Thrombosis Arterial Thrombosis Arterial Stenosis Urologic Complications Lymphocele Infections Outcomes Pancreas Transplantation Patient Selection Pancreas Donor Pancreas Procurement, Preparation, and Transplantation Drainage Techniques Exocrine Drainage Surgical Complications Leak Outcomes Islet Transplantation Isolation and Infusion Techniques Outcomes Selected References References 28 - Small Bowel Transplantation History Indications for Intestine Transplantation Evaluation Recipient Evaluation Donor Evaluation Donor and Recipient Surgical and Technical Considerations Isolated Intestine Transplantation Intestine Allograft in Combination with Other Abdominal Organs Other Technical Variations Immunosuppression Complications Surgical and Perioperative Complications Monitoring and Rejection Infection Outcomes Patient and Graft Survival Cost Quality of Life Conclusion Selected References References V - Surgical Oncology 29 - Tumor Biology and Tumor Markers Selected References References 30 - Tumor Immunology and Immunotherapy OVERVIEW OF TUMOR IMMUNOLOGY IMMUNOTHERAPY CONCLUSION SELECTED REFERENCES REFERENCES 31 - Melanoma and Cutaneous Malignancies Melanoma Epidemiology Precursor Lesions Pathogenesis Initial Evaluation Biopsy Pathology Staging AJCC Staging Beyond the AJCC TNM Staging Additional Workup and Imaging Treatment Wide Local Excision Evaluation and Management of Regional Lymph Nodes Adjuvant Therapy Surveillance Treatment of Locoregional Recurrent Disease Treatment of Metastatic Disease Special Situations and Noncutaneous Melanoma Unknown Primary Melanoma Melanoma and Pregnancy Noncutaneous Melanoma Nonmelanoma Skin Cancers Squamous Cell Carcinoma Presentation and Risk Factors Treatment Basal Cell Carcinoma Presentation and Risk Factors Treatment Merkel Cell Carcinoma Other Cutaneous Malignancies Cutaneous Angiosarcoma Dermatofibrosarcoma Protuberans Kaposi Sarcoma Extramammary Paget Disease Selected References References 32 - Soft Tissue Sarcoma EPIDEMIOLOGY CORE CONCEPTS Germline Mutations Neurofibromatosis Type 1 Li-Fraumeni Syndrome Familial Adenomatous Polyposis and Gardner Syndrome Radiation Carcinogens Gene Fusions and Molecular Testing Staging Tumor Grade Clinical Evaluation Lipomatous Tumors Malignant Fibrous Histiocytoma Reclassification TRUNK AND EXTREMITY SARCOMA Malignant Peripheral Nerve Sheath Tumors Desmoid Tumor Angiosarcoma Dermatofibrosarcoma Protuberans RETROPERITONEAL AND VISCERAL SARCOMA Gastrointestinal Stromal Tumor Leiomyosarcoma SUMMARY SELECTED REFERENCES REFERENCES 33 - Bone Tumors OVERVIEW BONE MICROENVIRONMENT BONE MACROENVIRONMENT BIOPSY STAGING ONCOLOGIC RESECTION SKELETAL RECONSTRUCTION Skeletal Stabilization Utilized in Intralesional Resections Skeletal Reconstruction Utilized in Wide Resections Allograft Arthroplasty Amputation BENIGN BONE TUMORS Enchondroma Osteochondroma Osteoid Osteoma Giant Cell Tumor SKELETAL SARCOMAS Osteosarcoma Ewing Sarcoma Chondrosarcoma BONE METASTASES CONCLUSION SELECTED REFERENCES REFERENCES VI - HEAD AND NECK 34 - Head and Neck NORMAL HISTOLOGY Epidemiology Carcinogenesis Staging Clinical Overview Evaluation Lymphatic Spread Therapeutic Options Anatomic Sites Neck Oral Cavity Oral Cavity Malignancy Oral Cavity Cancer Treatment Subsites of the Oral Cavity Oropharynx Anatomy Oropharyngeal Cancer and Treatment Hypopharynx Anatomy Hypopharyngeal Cancer and Therapy Larynx Anatomy Laryngeal Cancer and Therapy Treatment of Larynx Cancer Complications and Morbidity following Nonsurgical Treatment Speech and Swallowing Rehabilitation Salivary Anatomy Nonneoplastic Salivary Disease Neoplasms of the Salivary Glands Salivary Cancer and Therapy Surgical Technique Nasal Cavity and Paranasal Sinuses Anatomy Pathology of the Nasal Cavity and Paranasal Sinuses Evaluation and Treatment of Sinonasal Cancer Nasopharynx Anatomy Pathology of the Nasopharynx Parasellar and Pituitary Skull Base Surgery Ear and Temporal Bone Anatomy Pathology of the Ear and Temporal Bone Evaluation of Ear and Temporal Bone Tumors Treatment of Ear and Temporal Bone Tumors Head and Neck Reconstruction Reconstructive Goal 1: Separation of Upper Aerodigestive Tract From Sterile Compartments Reconstructive Goal 2: Optimizing Function Reconstructive Goal 3: Optimization of Form/Cosmesis Reconstructive Options in Head and Neck Surgery Secondary Intention Primary Closure Nonvascularized Grafts Adjacent Tissue Transfer and Local Flaps Regional Flaps Free Tissue Transfer Virtual Surgical Planning for Reconstruction of the Facial Skeleton Selected References Videos References VII - Breast 35 - Diseases of the Breast ANATOMY Microscopic Anatomy Breast Development and Physiology Normal Development and Physiology Fibrocystic Changes and Breast Pain Abnormal Development and Physiology Absent or Accessory Breast Tissue Gynecomastia Nipple Discharge Galactocele Diagnosis of Breast Disease Patient History Physical Examination Biopsy Fine-Needle Aspiration Core Needle Biopsy Excisional Biopsy Breast Imaging Screening Mammography Ultrasonography Magnetic Resonance Imaging Nonpalpable Mammographic Abnormalities Image-Localized Surgical Excision of Nonpalpable Breast Lesions Risk Factors for Breast Cancer Age and Gender Personal History of Cancer Histologic Risk Factors Family History of Breast Cancer and Genetic Risk Factors Reproductive Risk Factors Exogenous Hormone Use Risk Assessment Care of High-Risk Patients Close Surveillance Chemoprevention for Breast Cancer Prophylactic Mastectomy Summary: Risk Assessment and Management Benign Breast Tumors and Related Diseases Breast Cysts Fibroadenomas and Other Benign Tumors Hamartomas and Adenomas Breast Infections and Abscess Papillomas and Papillomatosis Sclerosing Adenosis Radial Scars Fat Necrosis Epidemiology and Pathology of Breast Cancer Epidemiology Pathology Noninvasive Breast Cancer Invasive Breast Cancer Molecular Markers and Breast Cancer Subtypes Staging of Breast Cancer Surgical Treatment of Breast Cancer Historical Perspective Surgical Trials of Local Therapy for Operable Breast Cancer Radical Mastectomy Versus Total Mastectomy With or Without Radiation Therapy Mastectomy Versus Breast-Conserving Therapy Planning Surgical Treatments Selection of Surgical Therapy Factors Influencing Eligibility for Breast Conservation Tumor Size Margins Histology Patient Age Breast-Conserving Surgery Technical Aspects Cosmetic Challenges Timing of Oncoplastic Surgery Mastectomy Indications Postmastectomy Breast Reconstruction Technical Details Lymph Node Staging Historical Perspective Sentinel Lymph Node Dissection Lymphatic Mapping Technique and Selection of Patients for Sentinel Lymph Node Dissection Outcomes of Sentinel Lymph Node Dissection Treatment of Ductal Carcinoma in situ Mastectomy Breast-Conserving Therapy Role of Tamoxifen and Aromatase Inhibitors Sentinel Node Surgery Radiation Therapy for Breast Cancer Radiation Therapy after Breast-Conserving Surgery Postmastectomy Radiation Therapy Systemic Therapy for Breast Cancer Goals of Therapy and Assessment of Potential Benefits and Risks from Therapy Chemotherapy HER-2–Based Targeted Therapy Endocrine Therapy Tamoxifen Aromatase Inhibitors Ovarian Ablation Neoadjuvant Systemic Therapy for Operable Breast Cancer Treatment of Special Conditions Breast Cancer in Older Adults Paget Disease Breast Cancer in Men Selected References References 36 - Breast Reconstruction BREAST CONSERVATION THERAPY—ONCOPLASTIC TECHNIQUES Reconstruction After Mastectomy Contralateral Breast Radiation Quality Measurements and Outcomes Alloplastic Reconstruction Timing—Immediate Versus Delayed Delayed Immediate Delayed-Immediate Location of Implant—Prepectoral Versus Subpectoral Complications Autologous Breast Reconstruction Pedicled Flaps (TRAM, Latissimus) Complications Combination of Reconstruction Techniques With or Without Implants Nipple-Areola Reconstruction Conclusion Selected References References VIII - Endocrine 37 - Thyroid Disclosures History of Thyroid Surgery Thyroid Embryology and Anatomy Embryology Median Thyroid Anlage Lateral Thyroid Anlage Thyroglossal Duct Cyst Ectopic Thyroid Tissue Anatomy Blood and Lymphatic Supply Nerves Associated With the Thyroid Gland Thyroid Histology and Physiology Histology Normal Thyroid Physiology Thyroid Hormone Calcitonin Thyroid Physiology in Pregnancy Thyroid Physiology in Nonthyroidal Illness (Euthyroid Sick Syndrome) Thyroid Biomarkers Thyroid-Stimulating Hormone Tetraiodothyronine and Triiodothyronine Thyroid Autoantibodies Thyroglobulin Calcitonin Thyroid Imaging Neck Ultrasound Nuclear Scintigraphy Cross-Sectional Imaging Positron Emission Tomography Hypothyroidism Autoimmune Thyroiditis Subacute Thyroiditis Riedel Thyroiditis Acute Suppurative Thyroiditis Iatrogenic Hypothyroidism Hyperthyroidism Graves Disease Toxic Multinodular Goiter Solitary Toxic Adenoma Amiodarone-Induced Thyrotoxicosis Nontoxic Goiter Endemic (Diffuse) Goiter Nontoxic Multinodular Goiter Substernal Goiter Workup Management THYROID NODULE Clinical Presentation and Workup Ultrasound Evaluation of Thyroid Nodules Sonographic Risk Stratification of Thyroid Nodules FNA Cytology Molecular Testing of FNA Specimens Thyroid Cancer Incidence Differentiated Thyroid Cancer A New Entity: Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features Thyroid Follicular Cell Neoplasia and Oncogenesis Risk Factors Clinical Presentation Imaging Workup Staging Surgical Management Active Nonoperative Surveillance of PTC Postoperative Thyroid-Stimulating Hormone Suppression Radioactive Iodine Adjuvant Therapies Medullary Thyroid Cancer Clinical Presentation RET and MTC Workup Surgical Treatment Postoperative Surveillance and Adjuvant Therapies Staging and Prognosis Anaplastic Thyroid Cancer Systemic Therapies for Advanced Thyroid Cancers Thyroidectomy Indications and Nomenclature Thyroidectomy Outcomes Preoperative Preparation Assessment of Voice and Laryngeal Function Technique Anesthesia and Positioning Incision and Initial Exposure of the Thyroid Dissection and Release of the Superior Pole Mobilization of Inferior Pole and Medial Rotation of the Thyroid Lobe Identification of the RLN and Completion of Lobectomy Closure Postoperative Care and Complications Complications Adjunctive Technologies During Thyroidectomy Energy Sealing Devices and Hemostatic Agents Intraoperative Neuromonitoring Fluorescent Imaging Aids for Parathyroid Identification Alternative Approaches to Thyroidectomy Selected References References 38 - The Parathyroid Glands History of the Parathyroid Glands Embryology of the Parathyroid Glands Histology of the Parathyroid Glands Parathyroid Physiology Primary Hyperparathyroidism Etiology, Pathophysiology, and Risk Factors Clinical Manifestations Diagnosis and Evaluation Management Indications for Parathyroidectomy Parathyroid Localization Surgical Options and Intraoperative Adjuncts Postoperative Management Medical Management of Primary Hyperparathyroidism Outcomes After Surgery Secondary and Tertiary Hyperparathyroidism Secondary Hyperparathyroidism Tertiary Hyperparathyroidism Calciphylaxis Parathyroid Cancer Familial Primary Hyperparathyroidism Selected References References 39 - Endocrine Pancreas Embryology of the Endocrine Pancreas Histomorphology of Islets Endocrine Physiology Glucose Homeostasis: Insulin and Glucagon Insulin Glucagon Other Influences on Glucose Homeostasis Somatostatin Pancreatic Polypeptide Other Peptide Hormones Pancreatic Neuroendocrine Tumors Overview and History Histopathology and Staging Molecular Genetics of PNETs General Principles of Diagnosis and Treatment of PNETs Diagnosis and Evaluation Screening for Functional Tumors Localization Treatment of Nonmetastatic, Symptomatic PNETs Localized Preoperatively Incidentally Found, Small, Nonfunctional PNETs Nonmetastatic Pancreatic Neuroendocrine Tumors—Unlocalized Preoperatively Metastatic Disease Liver Surgery for Metastatic Disease Liver-Directed Therapy for Metastatic Disease Cytotoxic and Targeted Systemic Therapy Liver Transplantation for Metastatic PNETs Diagnosis and Treatment of Specific Functional Pancreatic Neuroendocrine Tumors Insulin-Secreting Pancreatic Neuroendocrine Tumors (Insulinoma) Gastrin-Secreting Pancreatic Neuroendocrine Tumor (Gastrinoma) Vasoactive Intestinal Peptide–Secreting Pancreatic Neuroendocrine Tumor Glucagon-Secreting Pancreatic Neuroendocrine Tumor (Glucagonoma) Somatostatin-Secreting PNET (Somatostatin) Other Functional Pancreatic Endocrine Tumors Multiple Endocrine Neoplasia Type 1–Associated Pancreatic Neuroendocrine Tumor Postgastric Bypass Noninsulinoma Pancreatogenous Hypoglycemia Syndrome Endocrine Insufficiency After Surgical Resection Surgical Treatment of Diabetes Autologous Islet Cell Transplantation Pancreatic Transplantation and Islet Allotransplantation Selected References References 40 - The Adrenal Glands History Anatomy and Embryology General and Developmental Aspects Relationships Vasculature Normal Histopathology Biochemistry and Physiology Adrenal Steroid Biosynthesis Steroid Hormone Physiology and Metabolism Glucocorticoids Mineralocorticoids Adrenal Sex Steroids Catecholamine Biosynthesis and Physiology Catecholamine Clearance Adrenal Insufficiency Types of Adrenal Insufficiency Primary Adrenal Insufficiency (Addison Disease) Secondary Adrenal Insufficiency Adrenal Insufficiency in the Critically Ill Adrenal Crisis Diagnosis and Treatment Diagnosis Treatment Perioperative Steroid Administration Diseases of the Adrenal Cortex Primary Hyperaldosteronism Epidemiology and Clinical Features Surgical Management and Outcomes Cushing Syndrome Epidemiology and Clinical Features Biochemical Diagnosis and Localization Surgical Management and Outcomes Special Case: Subclinical Cushing Syndrome Sex Steroid Excess Adrenocortical Carcinoma Diseases of the Adrenal Medulla Pheochromocytoma Epidemiology and Clinical Features Special Case: Pheochromocytoma in Pregnancy Biochemical Diagnosis and Localization Perioperative Care Surgical Management and Outcomes Molecular Genetics of Pheochromocytoma Malignant Pheochromocytoma Other Adrenal Diseases Incidentally Discovered Adrenal Mass (Incidentaloma) Epidemiology and Differential Diagnosis Clinical Evaluation and Surgical Management Metastases to the Adrenal Gland Epidemiology and Clinical Features Clinical Evaluation and Surgical Management Technical Aspects of Adrenalectomy Choice of Operative Approach Laparoscopic Lateral Transabdominal Adrenalectomy Patient Preparation and Positioning Posterior Retroperitoneoscopic Adrenalectomy Complications and Postoperative Care Open Anterior Transabdominal Adrenalectomy Patient Preparation and Positioning Complications and Postoperative Care Selected References References 41 - The Multiple Endocrine Neoplasia Syndromes MULTIPLE ENDOCRINE NEOPLASIA TYPE 1 Incidence and Epidemiology Genetics Clinical Features and Management Parathyroid Glands Enteropancreatic NETs Pituitary Gland Other Tumors MULTIPLE ENDOCRINE NEOPLASIA TYPE 2 RET Proto-oncogene Multiple Endocrine Neoplasia Type 2A and Familial Medullary Thyroid Cancer Multiple Endocrine Neoplasia Type 2B Genetic Testing for Multiple Endocrine Neoplasia Type 2 Medullary Thyroid Cancer Surgery for Medullary Thyroid Cancer Recurrent and Metastatic Disease Pheochromocytoma Primary Hyperparathyroidism CONCLUSION SELECTED REFERENCES REFERENCES IX - Esophagus 42 - Esophagus ANATOMY Esophageal Inlet Esophageal Layers Anatomic Narrowing Gastroesophageal Junction Vasculature Lymphatics Innervation PHYSIOLOGY Swallowing Reflux Mechanism DIAGNOSIS AND MANAGEMENT OF ESOPHAGEAL MOTILITY DISORDERS Diagnosis Motility Disorders of the Esophageal Body Diffuse Esophageal Spasm Nutcracker Esophagus Motility Disorders of the Lower Esophageal Sphincter Hypertensive Lower Esophageal Sphincter Motility Disorders Affecting Both Body and Lower Esophageal Sphincter Achalasia Ineffective Esophageal Motility DIVERTICULAR DISORDERS Pharyngoesophageal (Zenker) Diverticulum Midesophageal Diverticula Epiphrenic Diverticula GASTROESOPHAGEAL REFLUX DISEASE Medical Management Workup Surgical Therapy Complicated GERD ACQUIRED BENIGN DISORDERS OF THE ESOPHAGUS Acquired Esophageal Disease Perforation Caustic Ingestion Foreign Body Ingestion, Benign Tracheoesophageal Fistula, and Schatzki Ring BENIGN AND RARE TUMORS OF THE ESOPHAGUS Benign Tumors of the Esophagus Rare Malignant Tumors of the Esophagus ESOPHAGEAL CANCER Epidemiology of Esophageal Cancer Diagnosis and Staging of Esophageal Cancer Approach to Early-Stage Esophageal Cancer High-Grade Dysplasia and Superficial Cancers Locally Advanced Esophageal Cancer Principles of Multimodality Therapy for Locally Advanced Esophageal Cancer The Role of Surgery in Trimodality Therapy and Salvage Surgery Surveillance Palliative Options for Esophageal Cancer SUMMARY ANNOTATED REFERENCES REFERENCES 43 - Gastroesophageal Reflux Disease and Hiatal Hernia GASTROESOPHAGEAL REFLUX DISEASE Pathophysiology Clinical Presentation Typica Symptoms of GERD Extraesophageal Symptoms of GERD Pulmonary Disease, GERD, and Antireflux Surgery Physical Examination Preoperative Diagnostic Testing Ambulatory pH and Impedance Monitoring Esophageal Manometry Esophagogastroduodenoscopy Barium Esophagram Additional Preoperative Considerations Dysphagia Obesity Ineffective Esophageal Motility Barrett Esophagus Treatment of GERD Medical Management Surgical Management Operative Technique Creation of a 360-Degree Fundoplication Creation of a Partial Fundoplication Intraoperative Management of Short Esophagus Postoperative Care and Recovery Clinical Outcomes of Antireflux Surgery Operative Complications and Side Effects of Antireflux Surgery Alternative Operative Therapies for GERD Transoral Incisionless Fundoplication Magnetic Sphincter Augmentation PARAESOPHAGEAL HERNIA Pathophysiology Clinical Presentation Preoperative Evaluation Operative Repair Acute Gastric Volvulus SUMMARY SELECTED REFERENCES REFERENCES VIDEOS X - Abdomen 44 - Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum and Retroperitoneum ABDOMINAL WALL AND UMBILICUS Embryology Anatomy Subcutaneous Tissues Muscle and Investing Fasciae Preperitoneal Space and Peritoneum Vessels and Nerves of the Abdominal Wall Vascular Supply Innervation Abnormalities of the Abdominal Wall Congenital Abnormalities Malignant Neoplasms of the Abdominal Wall Desmoid Tumor Abdominal Wall Sarcoma Metastatic Disease Symptoms of Intraabdominal Disease Referred to the Abdominal Wall PERITONEUM AND PERITONEAL CAVITY Anatomy Physiology Peritoneal Disorders Ascites Malignant Neoplasms of the Peritoneum MESENTERY AND OMENTUM Embryology and Anatomy Physiology Diseases of the Omentum Omental Cysts Omental Torsion and Infarction Omental Neoplasms Omental Grafts and Transpositions Diseases of the Mesentery Mesenteric Cysts Acute Mesenteric Lymphadenitis Sclerosing Mesenteritis Intraabdominal (Internal) Hernias Internal Hernias Caused by Developmental Defects Acquired Internal Hernias Malignant Neoplasms of the Mesentery Mesenteric and Intraabdominal Desmoid Tumors RETROPERITONEUM Anatomy Operative Approaches Retroperitoneal Disorders Retroperitoneal Abscesses Retroperitoneal Hematomas Retroperitoneal Fibrosis Retroperitoneal Malignant Neoplasms Retroperitoneal Sarcoma SELECTED REFERENCES REFERENCES 45 - Hernias INGUINAL HERNIAS Incidence Anatomy of the Groin External Oblique Muscle and Aponeurosis Internal Oblique Muscle and Aponeurosis Transversus Abdominis Muscle and Aponeurosis and Transversalis Fascia Pectineal (Cooper) Ligament Inguinal Canal Preperitoneal Space Femoral Canal Diagnosis Classification Treatment Nonoperative Management Complications and Results of Inguinal Hernia Repair FEMORAL HERNIAS SPECIAL PROBLEMS Sliding Inguinal Hernia Recurrent Inguinal Hernia Strangulated Inguinal Hernia Bilateral Inguinal Hernias COMPLICATIONS AND RESULTS Surgical Site Infection Nerve Injuries and Chronic Pain Syndromes Ischemic Orchitis and Testicular Atrophy Injury to the Vas Deferens and Viscera Inguinal Hernia Recurrence Quality of Life VENTRAL HERNIAS Incidence Anatomy Diagnosis Classification Umbilical Hernia Epigastric Hernia Incisional Hernia Treatment: Operative Repair Results of Incisional Hernia Repairs UNUSUAL HERNIAS Types Spigelian Hernia Obturator Hernia Lumbar Hernia Interparietal Hernia Sciatic Hernia Perineal Hernia Loss of Domain Hernias Parastomal Hernia Repair Complications General Considerations Mesh Infection Seromas Enterotomy SELECTED REFERENCES REFERENCES 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 Pregnancy Pediatrics Critical Illness Immunocompromised Cardiac Patients Morbidly Obese Elderly Advanced Disease SUMMARY SELECTED REFERENCES REFERENCES 47 - Acute Gastrointestinal Hemorrhage ACUTE MANAGEMENT OF PATIENTS WITH GASTROINTESTINAL HEMORRHAGE Initial Evaluation Acute Exsanguination Localization Obscure Bleeding SPECIFIC CAUSES OF UGIB Nonvariceal Bleeding Peptic Ulcer Disease Esophagitis Gastritis Mallory-Weiss Tears Gastric Antral Vascular Ectasia Dieulafoy Lesion Hemobilia Malignancy Inflammatory Bowel Disease Aortoenteric Fistula Hemosuccus Pancreaticus Procedure-Related Bleeding Variceal Hemorrhage ACUTE LOWER GASTROINTESTINAL HEMORRHAGE Diagnosis Colonoscopy Angiography Surgical Management Specific Causes of Lower Gastrointestinal Tract Bleeding Diverticula Colitis Angiodysplasia/Arteriovenous Malformation Neoplasms Ischemia Infectious Diverticula Radiation Therapy SELECTED REFERENCES REFERENCES 48 - Morbid Obesity Obesity: The Magnitude of the Problem Medical Versus Surgical Therapy Bariatric Surgery Mechanism of Action The Enteroencephalic Endocrine Axis Enteroinsular Endocrine Axis Preoperative Evaluation and Selection Eligibility General Bariatric Preoperative Evaluation and Preparation Evaluation of Specific Comorbid Conditions Special Equipment Clinic Operating Room Operative Procedures Laparoscopic Adjustable Gastric Banding Roux-en-Y Gastric Bypass Biliopancreatic Diversion Duodenal Switch Laparoscopic Sleeve Gastrectomy Postoperative Care and Follow-Up Laparoscopic Adjustable Gastric Banding Roux-en-Y Gastric Bypass, Biliopancreatic Diversion, Duodenal Switch, and Laparoscopic Sleeve Gastrectomy Bariatric Surgery Results Laparoscopic Adjustable Gastric Banding Roux-en-Y Gastric Bypass Recovery After Roux-en-Y Gastric Bypass Is Improved After a Laparoscopic Approach Biliopancreatic Diversion and Duodenal Switch Laparoscopic Sleeve Gastrectomy Complications of Bariatric Surgery Laparoscopic Adjustable Gastric Banding Roux-en-Y Gastric Bypass Biliopancreatic Diversion and Duodenal Switch Laparoscopic Sleeve Gastrectomy Reoperative Surgery Preoperative Use of Endoscopy Intraoperative Endoscopy Postoperative Endoscopy Endoscopic Management of Complications After Bariatric Surgery Strictures After Bariatric Surgery Weight Regain After Bariatric Surgery Primary Endoscopic Weight Loss Procedures Controversies in Bariatric Surgery Conclusion Selected References References 49 - Stomach Anatomy Gross Anatomy Divisions Blood Supply Lymphatic Drainage Innervation Gastric Morphology Gastric Microscopic Anatomy Physiology Regulation of Gastric Function Gastric Peptides Gastrin Somatostatin Histamine Ghrelin Gastric Acid Secretion Stimulated Acid Secretion Activation and Secretion by the Parietal Cell Pharmacologic Regulation Gastric Motility Fasting Gastric Motility Postprandial Gastric Motility Abnormal Gastric Motility Gastric-Emptying Studies Treatment Gastric Barrier Function Peptic Ulcer Disease Epidemiology Pathogenesis Helicobacter pylori Infection Nonsteroidal Antiinflammatory Drugs Gastric Ulcers Clinical Manifestations Diagnosis and Treatment Duodenal Ulcer Diagnosis Medical Treatment Complicated Ulcer Disease Surgical Procedures for Peptic Ulcers Stress Gastritis Pathophysiology Presentation and Diagnosis Prophylaxis Treatment Postgastrectomy Syndromes Dumping Syndrome Metabolic Disturbances Afferent Loop Syndrome Efferent Loop Obstruction Alkaline Reflux Gastritis Gastric Atony Gastric Cancer Epidemiology Risk Factors Helicobacter pylori Infection Dietary Factors Hereditary Risk Factors and Cancer Genetics Polyps Proton pump inhibitors Other Risk Factors Pathology Diagnosis and Workup Signs and Symptoms Screening Staging Staging Workup Treatment Surgical Therapy Endoscopic Resection Extent of Lymph Node Dissection Locally Advanced Gastric Cancer Adjuvant and Neoadjuvant Therapy Palliative Therapy and Systemic Therapy Outcomes Recurrence Gastric Lymphoma Epidemiology Pathology Evaluation and Staging Treatment Mucosa-Associated Lymphoid Tissue Lymphomas Treatment Gastrointestinal Stromal Tumors Adjuvant Therapy Other Neoplasms Gastric Neuroendocrine Tumors Heterotopic Pancreas Other Gastric Lesions Hypertrophic Gastritis (Ménétrier Disease) Mallory-Weiss Tear Dieulafoy Gastric Lesion Gastric Varices Gastric Volvulus Gastric Bezoars Selected References References 50 - Small Intestine Embryology Anatomy Gross Anatomy Neurovascular-Lymphatic Supply Microscopic Anatomy Physiology Digestion and Absorption Carbohydrates Protein Water, Electrolytes, and Vitamins Motility Endocrine Function Gastrointestinal Hormones Receptors Immune Function Obstruction Causes Pathophysiology Clinical Manifestations and Diagnosis History Physical Examination Laboratory and Radiologic Studies Simple Versus Strangulating Obstruction Treatment Fluid Resuscitation and Antibiotics Tube Decompression Contrast Challenge Operative Management Management of Specific Problems Recurrent Intestinal Obstruction Acute Postoperative Obstruction Ileus Inflammatory and Infectious Diseases Crohn Disease History Incidence and Epidemiology Etiology Pathology Clinical Manifestations Diagnosis Prognosis Typhoid Enteritis Enteritis in the Immunocompromised Host Protozoa Bacteria Mycobacteria Viruses Fungi Neoplasms General Considerations Clinical Manifestations Diagnosis Benign Neoplasms Stromal Tumors Malignant Neoplasms Neuroendocrine Neoplasms Adenocarcinomas Lymphoma Gastrointestinal Stromal Tumors Metastatic Neoplasms Diverticular Disease Duodenal Diverticula Incidence and Cause Clinical Manifestations Treatment Jejunal and Ileal Diverticula Incidence and Cause Clinical Manifestations Treatment Meckel Diverticulum Incidence and Cause Clinical Manifestations Diagnostic Studies Treatment Miscellaneous Problems Small Bowel Ulcerations Ingested Foreign Bodies Small Bowel Fistulas Clinical Manifestations Pneumatosis Intestinalis Blind Loop Syndrome Radiation Enteritis Short Bowel Syndrome Treatment Vascular Compression of the Duodenum Selected References References 51 - The Appendix Anatomy and Embryology Videos Appendicitis History Pathophysiology and Bacteriology Differential Diagnosis Presentation History Physical Examination Laboratory Studies Imaging Studies Treatment of Appendicitis Acute Uncomplicated Appendicitis Perforated Appendicitis Laparoscopic Versus Open Appendectomy Delayed Presentation of Appendicitis The Normal-Appearing Appendix at Operation “Chronic” Appendicitis as a Cause of Abdominal Pain Incidental Appendectomy Appendicitis in Special Populations Appendicitis in the Pregnant Patient Appendicitis in the Elderly Appendicitis in the Immunocompromised Patient Neoplasms of the Appendix Selected References References 52 - Colon and Rectum EMBRYOLOGY OF THE COLON AND RECTUM ANATOMY OF THE COLON, RECTUM, AND PELVIC FLOOR PHYSIOLOGY OF THE COLON PREOPERATIVE EVALUATION SELECTED REFERENCES REFERENCES 53 - Anus Anatomy Physiology Diagnosis History Physical Examination Imaging Common Benign Disorders of the Anus Internal Hemorrhoids Anal Fissure Abscess/Fistula (Including Rectovaginal Fistula) Pilonidal Sinus Sexually Transmitted Diseases Hidradenitis Suppurativa Perianal Crohn Disease Anorectal Emergencies Fourth-Degree Hemorrhoids Fournier Gangrene Immunocompromised States Horseshoe Abscess Incarcerated Rectal Prolapse Pelvic Floor Neoplasms Anal Intraepithelial Neoplasia Squamous Cell Carcinoma Perianal Paget Disease Basal Cell Carcinoma Malignant Melanoma Adenocarcinoma of the Anal Canal Selected References References 54 - The Liver Historical Perspective Anatomy and Physiology Anatomy Gross Anatomy Functional Anatomy Functions Energy Functional Heterogeneity Blood Flow Bile Formation Enterohepatic Circulation Bilirubin Metabolism Carbohydrate Metabolism Lipid Metabolism Protein Metabolism Vitamin Metabolism Coagulation Metabolism of Drugs and Toxins (Xenobiotics) Regeneration Future Developments Assessment of Liver Function Routine Screening Tests Specific Diagnostic Tests Quantitative Tests Portal Hypertension Definition Pathophysiology Assessment of Chronic Liver Disease and Portal Hypertension Variceal Hemorrhage Treatment Prevention of Recurrent Variceal Hemorrhage Algorithm for Management of Variceal Hemorrhage Infectious Diseases Pyogenic Abscess Epidemiology Pathogenesis Pathology and Microbiology Clinical Features Differential Diagnosis Treatment Outcomes Amebic Abscess Epidemiology Pathogenesis Pathology Clinical Features Differential Diagnosis Treatment Outcomes Hydatid Cyst Recurrent Pyogenic Cholangitis Neoplasms Solid Benign Neoplasms Liver Cell Adenoma Focal Nodular Hyperplasia Hemangioma Other Benign Tumors Primary Solid Malignant Neoplasms Hepatocellular Carcinoma Intrahepatic Cholangiocarcinoma Other Primary Malignant Neoplasms Metastatic Tumors Colorectal Metastases Neuroendocrine Metastases Noncolorectal, Nonneuroendocrine Metastases Cystic Neoplasms Simple Cyst Cystadenoma and Cystadenocarcinoma Polycystic Liver Disease Bile Duct Cysts Principles of Hepatic Resection Hemobilia Causes Clinical Presentation Diagnostic Workup Treatment and Outcomes Bilhemia Viral Hepatitis and the Surgeon Definition Diagnosis Epidemiology and Transmission Pathogenesis and Clinical Presentation Prevention Treatment Selected References References 55 - Biliary System Anatomy and Physiology Vascular Anatomy Biliary Tree Pathophysiology Laboratory Tests Imaging Studies Plain Films Ultrasound Hepatic Iminodiacetic Acid Scan Computed Tomography Magnetic Resonance Imaging and Magnetic Resonance Cholangiopancreatography Endoscopic Retrograde Cholangiopancreatography Percutaneous Transhepatic Cholangiography Intraoperative Cholangiography Endoscopic Ultrasound Fluorodeoxyglucose Positron Emission Tomography Bacteriology Benign Biliary Disease Calculous Biliary Disease Natural History Nonoperative Treatment of Cholelithiasis Chronic Cholecystitis Diagnosis Treatment Acute Calculous Cholecystitis Presentation Diagnosis Treatment Choledocholithiasis Diagnosis Treatment Gallstone Pancreatitis Gallstone Ileus Treatment Noncalculous Biliary Disease Acute Acalculous Cholecystitis Biliary Dyskinesia Sphincter of Oddi Dysfunction Primary Sclerosing Cholangitis Biliary Strictures Biliary Cysts Polypoid Lesions of the Gallbladder Benign Biliary Masses Surgery for Calculous Biliary Disease Laparoscopic Cholecystectomy Bailout Procedures Open Cholecystectomy Open CBD Exploration Laparoscopic CBD Exploration Postcholecystectomy Syndromes Bile Duct Injury Biliary Leak Lost Stones Postcholecystectomy Pain Retained Biliary Stones Acute Cholangitis Recurrent Pyogenic Cholangitis Malignant Biliary Disease Gallbladder Cancer Incidence Cause Pathology and Staging Clinical Presentation Diagnosis Treatment Adjuvant Therapy Survival Bile Duct Cancer Risk Factors Staging and Classification Clinical Presentation Diagnosis and Assessment of Resectability Outcomes Metastatic and Other Tumors Selected References References 56 - Exocrine Pancreas ANATOMY Arterial Blood Supply Venous Drainage EMBRYOLOGY Annular Pancreas Ectopic Pancreas Pancreas Divisum PHYSIOLOGY Major Components of Pancreatic Juice Phases and Regulation of Pancreatic Secretion ACUTE PANCREATITIS Pathophysiology Risk Factors Biliary or Gallstone Pancreatitis Alcohol-Induced Injury Anatomic Obstruction Endoscopic Retrograde Cholangiopancreatography–Induced Pancreatitis Drug-Induced Pancreatitis Metabolic Factors Miscellaneous Conditions Clinical Manifestations Diagnosis Imaging Studies Assessment of Severity of Disease Treatment Complications Sterile and Infected Peripancreatic Fluid Collections Pancreatic Necrosis and Infected Necrosis Pancreatic Pseudocysts Pancreatic Ascites and Pancreaticopleural Fistulas Vascular Complications Pancreatocutaneous Fistula CHRONIC PANCREATITIS Risk Factors Alcohol Abuse Smoking Gene Mutations Types of Chronic Pancreatitis Autoimmune Pancreatitis Tropical Pancreatitis Idiopathic Pancreatitis Clinical Manifestations Diagnosis Imaging Studies Functional Tests Treatment Medical Treatment Pain Management Pancreatic Exocrine Insufficiency Endocrine Insufficiency Interventional Therapy: Endoscopic Treatment Surgical Treatment CYSTIC NEOPLASMS OF THE PANCREAS Types of Cystic Neoplasms Serous Cystic Neoplasm Mucinous Cystic Neoplasm Intraductal Papillary Mucinous Neoplasm Management Strategies for Intraductal Papillary Mucinous Neoplasm Treatment: Surgical Resection for Intraductal Papillary Mucinous Neoplasm ADENOCARCINOMA OF THE EXOCRINE PANCREAS Epidemiology Risk Factors Environmental Risk Factors and Causes Hereditary Risk Factors Pathogenesis of Sporadic Pancreatic Cancer Genetic Progression of Pancreatic Intraepithelial Neoplasia to Invasive Pancreatic Ductal Adenocarcinoma Clinical Presentation Diagnosis Laboratory Evaluation Imaging Studies Staging Laparoscopy Treatment Surgery for Tumors of the Head of the Pancreas Surgery for Tumors of the Body and Tail of the Pancreas Laparoscopic Distal Pancreatectomy Outcomes Perioperative Mortality: Long-Term Survival Morbidity Controversies Palliative Bypass in the Case of Unresectable/Metastatic Disease Pylorus-Preserving versus Non–Pylorus-Preserving Whipple Procedure Pancreaticojejunostomy Versus Pancreatogastrostomy Use of Somatostatin Analogues to Reduce Pancreatic Fistula Extent of Lymphadenectomy Laparoscopic and Robotic Pancreaticoduodenectomy Antecolic versus Retrocolic Duodenojejunostomy Drain Versus No Drain Irreversible Electroporation Adjuvant Therapy for Pancreatic Cancer Chemotherapy and Radiation Therapy Role of Neoadjuvant Therapy Chemotherapy for Metastatic Pancreatic Adenocarcinoma Palliative Therapy for Pancreatic Cancer Biliary Obstruction Gastric Outlet Obstruction Pain Relief PANCREATIC TRAUMA SELECTED REFERENCES REFERENCES 57 - The Spleen SPLENIC ANATOMY SPLENIC FUNCTION SPLENECTOMY SELECTED REFERENCES REFERENCES XI - Chest 58 - Lung, Chest Wall, Pleura and Mediastinum ANATOMY Physiologic Evaluation LUNG Congenital Lesions of the Lung Congenital Abnormalities of the Trachea and Bronchi Congenital Vascular Disorders LUNG CANCER Pathology Screening Diagnosis Staging Evaluation of Tumor (T) Stage Evaluation of Nodal (N) Stage Evaluation of Metastasis (M) Stage Current Lung Cancer Eighth Edition Staging System Tumor (T) Lymph Nodes (N) Metastases (M) Results of Treatment for Lung Cancer Local Therapy for Early-Stage Non–Small Cell Lung Cancer Neoadjuvant and Adjuvant Therapy Treatment of Metastatic Disease TRACHEA Benign Stenosis of the Trachea Primary Neoplasm of the Trachea Tracheal Trauma Principles of Tracheal Surgery PULMONARY INFECTIONS Bronchiectasis Lung Abscess Other Bronchopulmonary Disorders Mycobacterial Infections Fungal and Parasitic Infections MASSIVE HEMOPTYSIS EMPHYSEMA AND DIFFUSE LUNG DISEASE Emphysema Diffuse Lung Disease Adult Respiratory Distress Syndrome PULMONARY METASTASES MISCELLANEOUS LUNG TUMORS CHEST WALL Congenital Deformities Pectus Excavatum Pectus Carinatum Chest Wall Tumors General Bone Tumors Soft Tissue Tumors Metastatic Tumors Chest Wall Infections Chest Wall Trauma THORACIC OUTLET SYNDROME Diagnosis Management PLEURA Pleural Effusions Benign Pleural Effusions Malignant Pleural Effusion Empyema Chylothorax Pneumothorax Mesothelioma Solitary Fibrous Tumor of the Pleura MEDIASTINUM Anterosuperior Compartment Middle Compartment Posterior or Paravertebral Sulci Compartment Clinical Manifestations and Diagnosis Evaluation and Diagnostic Imaging Histologic Diagnosis PRIMARY MEDIASTINAL CYSTS PRIMARY MEDIASTINAL NEOPLASMS Thymoma Germ Cell Tumors Teratomas Malignant Nonteratomatous Germ Cell Tumors Seminomas Nonseminomatous Tumors Neurogenic Tumors Neuroblastoma Ganglion Tumors Paraganglioma (Pheochromocytoma) Lymphomas Endocrine Tumors Thyroid Tumors Parathyroid Tumors Neuroendocrine Tumors SELECTED REFERENCES REFERENCES 59 - Congenital Heart Disease HISTORY AND OTHER CONSIDERATIONS ANATOMY, TERMINOLOGY, AND DIAGNOSIS Anatomy and Terminology Diagnosis Physical Examination PERIOPERATIVE CARE Anesthesia Pitfalls Neurologic Outcomes LESION OVERVIEW Defects Associated With Increased Pulmonary Blood Flow Persistent Arterial Duct (Patent Ductus Arteriosus) Aortopulmonary Septal Defect (Aortopulmonary Window) Atrial Septal Defect Ventricular Septal Defect Perimembranous Ventricular Septal Defect Muscular Ventricular Septal Defect Subarterial (Supracristal or Outlet) Ventricular Septal Defect Atrioventricular Septal Defect (Atrioventricular Canal Defect) Adult Patients With Atrioventricular Septal Defect Persistent Arterial Trunk (Truncus Arteriosus) Abnormalities of Venous Drainage Total Anomalous Pulmonary Venous Return Anomalous Systemic Venous Drainage Cyanotic Congenital Heart Disease Tetralogy of Fallot Pulmonary Atresia and Intact Ventricular Septum Pulmonary Atresia With Ventricular Septal Defect Valvular Pulmonic Stenosis Conotruncal Anomalies Transposition of the Great Arteries Double-Outlet Right Ventricle Congenitally Corrected Transposition of the Great Arteries (l-Transposition) Left Ventricular Outflow Tract Obstruction Valvular Aortic Stenosis Fibromuscular Subaortic Stenosis Tunnel Subaortic Stenosis Aortic Arch Anomalies Aortic Coarctation Interrupted Aortic Arch SINGLE VENTRICLE Tricuspid Atresia Hypoplastic Left Heart Syndrome Neonatal Cardiac Transplantation Norwood Reconstruction Sano Modification of the Norwood Operation Hybrid Procedure Fontan Operation MISCELLANEOUS ANOMALIES Vascular Rings and Pulmonary Artery Slings Vascular Rings Pulmonary Artery Slings Diagnosis and Indications for Intervention Surgery Coronary Artery Anomalies Anomalous Left Coronary Artery Rising From the Pulmonary Artery Coronary Arteriovenous Fistula and Aneurysms Ebstein Anomaly of the Tricuspid Valve Diagnosis and Intervention Surgery Mitral Valve Anomalies Mitral Stenosis SUMMARY SELECTED REFERENCES REFERENCES 60 - Acquired Heart Disease: Coronary Insufficiency CORONARY ARTERY ANATOMY AND PHYSIOLOGY Anatomic Considerations ATHEROSCLEROTIC CORONARY ARTERY DISEASE Pathogenesis Fixed Coronary Obstructions CLINICAL MANIFESTATIONS AND DIAGNOSIS OF CORONARY ARTERY DISEASE Clinical Presentation Physical Examination Diagnostic Testing Biochemical Studies Chest Radiography Resting Electrocardiography Functional (Stress) Tests Echocardiography Multidetector Computed Tomography Magnetic Resonance Imaging Cardiac Catheterization and Intervention Fractional Flow Reserve Intravascular Ultrasonography Hybrid Imaging Coronary Artery Bypass Grafting Versus Contemporaneous Medical Therapy Percutaneous Coronary Intervention Versus Medical Therapy Coronary Artery Bypass Grafting Versus Balloon Angioplasty or Bare-Metal Stents Coronary Artery Bypass Grafting Versus Drug-Eluting Stents Left Main Coronary Artery Disease CABG or PCI Versus Medical Therapy for Left Main CAD Studies Comparing PCI Versus CABG for Left Main CAD Revascularization Options for LCA CAD Proximal LAD Artery Disease Completeness of Revascularization Left Ventricular Systolic Dysfunction Revascularization Options for Previous CABG Unstable Angina/Non–ST-Segment Elevation Myocardial Infarction ST-Segment Elevation Myocardial Infarction–Acute Myocardial Infarction Percutaneous Coronary Intervention Versus Medical Management for Acute Myocardial Infarction Role of Coronary Artery Bypass Grafting Preoperative Evaluation Technique of Myocardial Revascularization: Conventional On-Pump Cardiopulmonary Bypass Positioning and Draping Cardiopulmonary Bypass Neurologic Protection During Cardiopulmonary Bypass Median Sternotomy Total Arterial Revascularization Cannulation for Cardiopulmonary Bypass Cardiac Arrest and Myocardial Protection Target Identification and Distal Anastomosis Separation from Cardiopulmonary Bypass Hemostasis Sternal Closure and Completion of Surgery ADJUNCTS TO CORONARY ARTERY BYPASS GRAFTING Transesophageal Echocardiography Inotropes and Pharmacotherapy Intraaortic Balloon Pump POSTOPERATIVE CARE Pulmonary Care Discharge From the Intensive Care Unit Outcomes Hospital Mortality Long-Term Survival Medical Adjuncts for Postoperative Management ALTERNATIVE METHODS FOR MYOCARDIAL REVASCULARIZATION On-Pump Beating-Heart Bypass Off-Pump Coronary Artery Bypass Grafting Minimally Invasive Direct Coronary Artery Bypass Robotics: Totally Endoscopic Coronary Artery Bypass Transmyocardial Laser Revascularization Hybrid Procedures Technical Aspects of Reoperative Coronary Artery Bypass Grafting MECHANICAL COMPLICATIONS OF CORONARY ARTERY DISEASE Left Ventricular Aneurysm Ventricular Septal Defect Mitral Regurgitation CORONARY ARTERY BYPASS GRAFTING AND SPECIAL POPULATIONS OF PATIENTS Patients With Diabetes Older Patients Women Patients With Renal Disease Obese Patients ACKNOWLEDGMENTS SELECTED REFERENCES REFERENCES 61 - Acquired Heart Disease: Valvular HISTORY OF HEART VALVE SURGERY VALVE ANATOMY Surgical Anatomic Relationships Mitral Stenosis Rheumatic Heart Disease Aortic Stenosis Mitral Regurgitation Aortic Insufficiency Endocarditis Right-Sided Valvular Disease PATHOPHYSIOLOGY OF VALVULAR HEART DISEASE VALVE DISEASE SYNDROMES Mitral Stenosis Interventional Management Percutaneous Balloon Mitral Commissurotomy Open Mitral Commissurotomy Mitral Valve Replacement Mitral Regurgitation Diagnostic Testing Natural History AORTIC STENOSIS Diagnosis of Aortic Stenosis Symptoms and Signs Physical Exam Diagnostic Testing Natural History Surgical treatment Aortic Insufficiency Diagnostic Testing Natural History Surgical Treatment Tricuspid Regurgitation and Other Right-Sided Valve Disease Natural History Mixed Valve Disease OPERATIVE APPROACHES Conduct of Heart Valve Surgery Mitral Valve Replacement and Repair Mitral Valve Replacement Mitral Valve Repair Surgical Aortic Valve Replacement and Aortic Valve Repair Prosthetic valves Transcatheter Aortic Valve Replacement and Other Emerging Technologies Percutaneous Mitral Interventions SELECTED REFERENCES REFERENCES XII - Vascular 62 - The Aorta EMBRYOLOGY, ANATOMY, AND NOMENCLATURE PATHOLOGY, MANAGEMENT, AND OUTCOMES Acute Aortic Syndromes Aortic Dissection, Intramural Hematoma, and Penetrating Aortic Ulcers Aortic Dissection Intramural Hematoma Penetrating Aortic Ulcer Blunt Thoracic Aortic Injury Acute Type A Aortic Dissection Aortic Root Replacement Open Surgery of the Descending Thoracic Aorta Thoracoabdominal Aortic Aneurysms Open Infrarenal Abdominal Aortic Aneurysm Repair Endovascular Principles Endovascular Approaches to the Thoracic Aorta REFERENCES 63 - Peripheral Arterial Disease EPIDEMIOLOGY AND DEMOGRAPHICS PATIENT PRESENTATIONS AND NATURAL HISTORY PATHOPHYSIOLOGY AND ANATOMY EVALUATION OF THE PATIENT WITH PERIPHERALARTERY DISEASE MEDICAL MANAGEMENT ASSESSMENT OF OUTCOMES SELECTED REFERENCES REFERENCES 64 - Vascular Trauma Mechanism of Injury and Pathophysiology Clinical Presentation Diagnosis Endovascular Management Endovascular Operating Rooms Endovascular Management of Torso Vascular Injuries Endovascular Management of Cerebrovascular Vascular Injuries Endovascular Management of Extremity Vascular Injuries Who Should Perform Endovascular Repairs Open Surgical Management Preparation for Operative Management Vascular Exposure and Control Vascular Damage Control Choice of Repair and Graft Material Intraoperative Imaging and Noninvasive Evaluation Role of Tissue Coverage Role of Fasciotomy Role of Immediate Amputation Common Errors and Pitfalls Specific Injuries Head, Neck, and Thoracic Outlet Intrathoracic Great Vessels Abdominal Vascular Injury Upper Extremity Lower Extremity Operative Techniques for Extremity Fasciotomy Postoperative Management Outcomes and Follow-Up General Surgery Training Vascular Fellowship Training Vascular Trauma Realities Need for Remedial Training and Review The Need for Action Selected References References 65 - Venous Disease Videos Anatomy Superficial Venous System Deep Venous System Venous System Perforators Normal Venous Histology and Function Venous Insufficiency Risk Factors Pathology Mechanical Abnormalities Symptoms Physical Examination Diagnostic Evaluation of Venous Dysfunction Phlebography and Venography Magnetic Resonance and Computed Tomography Venous Imaging Classification Systems Treatment of Superficial Venous Insufficiency Nonoperative Management Treatment Options for Telangiectasias Ultrasound-Guided Sclerotherapy Nontumescent Ablation and Future Modalities for Axial Vein Incompetence Treatment of Branch Varicosities Secondary Venous Insufficiency Deep Venous Thrombosis Lower Extremity Deep Venous Thrombosis Causes Stasis Hypercoagulable State Venous Injury Diagnostic Considerations Incidence Clinical Diagnosis Imaging Studies and Laboratory Tests Venography Impedance Plethysmography Fibrin and Fibrinogen Assays Duplex Ultrasound Magnetic Resonance Venous Imaging Prophylaxis Treatment Upper Extremity Deep Venous Thrombosis Treatment Superficial Thrombophlebitis Conclusion Selected References References Videos 66 - The Lymhatics EMBRYOLOGY AND ANATOMY FUNCTION AND STRUCTURE PATHOPHYSIOLOGY AND STAGING DIFFERENTIAL DIAGNOSIS CLASSIFICATION DIAGNOSTIC TESTS New Diagnostic Tests THERAPY General Therapeutic Measures Elevation and Compression Garments Complex Decongestive Physical Therapy Compression Pump Therapy Drug Therapy Molecular Lymphangiogenesis Operative Treatment CHYLOTHORAX CHYLOPERITONEUM TUMORS OF THE LYMPHATICS SELECTED REFERENCES REFERENCES XIII - Specialties in General Surgery 67 - Pediatric Surgery NEONATAL PHYSIOLOGY Cardiopulmonary FLUIDS, ELECTROLYTES, AND NUTRITION Fluid and Electrolytes Nutrition HEAD AND NECK LESIONS Dermoid and Epidermoid Cysts Lymphadenopathy Cystic Hygroma Thyroglossal Duct Cyst Branchial Cleft Remnants EXTRACORPOREAL LIFE SUPPORT Indications Physiology DIAPHRAGMATIC CONDITIONS Congenital Diaphragmatic Hernia Pathogenesis Clinical Presentation Management Surgical Repair Eventration of Diaphragm BRONCHOPULMONARY MALFORMATIONS Bronchogenic Cyst Congenital Pulmonary Airway Malformation Pulmonary Sequestration Congenital Lobar Emphysema ALIMENTARY TRACT CONDITIONS Esophageal Atresia and Tracheoesophageal Fistula Gastroesophageal Reflux Hypertrophic Pyloric Stenosis Intestinal Atresia Intestinal Malrotation and Midgut Volvulus Necrotizing Enterocolitis Short Bowel Syndrome Meconium Ileus Meconium Plug Syndrome Hirschsprung Disease Anorectal Malformation Intussusception Meckel Diverticulum Appendicitis HEPATOPANCREATICOBILIARY CONDITIONS Extrahepatic Biliary Atresia Choledochal Cyst Hereditary Pancreatitis and Pancreas Divisum Biliary Dyskinesia ABDOMINAL WALL CONDITIONS CHEST WALL DEFORMITIES GENITOURINARY TRACT CONDITIONS Cryptorchidism Testicular Torsion Testicular Tumors PEDIATRIC SOLID TUMORS Neuroblastoma Wilms Tumor Rhabdomyosarcoma Liver Tumors Teratoma Sacrococcygeal Teratomas Ovarian Tumor Germ Cell Tumors Sex Cord Tumors Epithelial Tumors PEDIATRIC TRAUMA Head and Spine Injuries Thoracic Trauma Abdominal Trauma Pancreatic Injury Renal Injury SELECTED REFERENCES REFERENCES 68 - Neurosurgery Intracranial Dynamics Cerebrovascular Disorders Arteriovenous Malformations Cavernous Malformations Capillary Telangiectasia Developmental Venous Anomaly: Venous Angioma Traumatic Fistula Aneurysms Saccular Aneurysms Spontaneous Intracerebral Hemorrhage Mycotic Aneurysms Moyamoya Disease Dural Arteriovenous Malformations Ischemic Strokes Central Nervous System Tumors Intracranial Tumors Clinical Presentation Imaging Studies Surgery Primary Brain Tumors Intraaxial Brain Tumors Oligodendroglioma Ependymoma Choroid Plexus Papilloma and Carcinoma Pediatric Brainstem Gliomas Neuronal and Mixed Neuronal-Glial Tumors Ganglioglioma and Gangliocytoma Central Neurocytoma Dysembryoplastic Neuroepithelial Tumor Paraganglioma Pineal Region Tumors Pineocytoma Pineoblastoma Papillary Tumor of the Pineal Region Primitive Neuroectodermal Tumors Tumors of Cranial and Spinal Nerves Schwannoma Neurofibroma Tumors of the Meninges Meningiomas Hemangioblastoma Lymphomas and Hematopoietic Tumors Primary Central Nervous System Lymphoma Plasmacytoma Germ Cell Tumors Tumors of the Sellar Region Central Nervous System Metastasis Traumatic Brain Injury Epidemiology Pathophysiology Prehospital and Emergency Department Management Treatment Degenerative Disorders of The Spine Degenerative Disease of the Lumbar Spine Lumbar Radiculopathy Lumbar Spinal Stenosis Lumbar Instrumentation and Fusion Degenerative Diseases of the Cervical Spine Cervical Radiculopathy Cervical Myelopathy Diagnosis and Treatment Functional And Stereotactic Neurosurgery Stereotactic Surgery Brain Stimulation Implantable Pumps Destructive Lesions Epilepsy Trigeminal Neuralgia Hydrocephalus Hydrocephalus and Pregnancy Abdominal Surgery in Patients With Ventriculoperitoneal Shunts Pediatric Neurosurgery Central Nervous System Infections Intracranial Infections Cranial Epidural Abscess Subdural Empyema Meningitis Brain Abscess Ventriculitis Postoperative Infections Posttraumatic Meningitis Spinal Infections Vertebral Osteomyelitis Discitis Spinal Epidural Abscess Acquired Immunodeficiency Syndrome Selected References References 69 - Plastic Surgery Reconstructive Techniques Primary and Secondary Wound Closure Skin Grafts Tissue Expansion Alloplastic Materials Flaps Local Flaps Muscle and Musculocutaneous Flaps Fascia and Fasciocutaneous Flaps Perforator Flaps Microvascular Free Tissue Transfer Supermicrosurgery Pediatric Plastic Surgery Craniofacial Surgery Congenital Ear Deformities Craniofacial Microsomia Cleft Lip and Palate Vascular Anomalies Pediatric Neck Masses Melanocytic Nevi Plastic Surgery of the Head and Neck Maxillofacial Trauma Emergent Management Evaluation and Diagnosis Soft Tissue Injuries Craniofacial Fractures Scalp Reconstruction Facial Reconstruction Facial Transplantation Facial Aesthetic Surgery Brow Lift Blepharoplasty Rhinoplasty Facelift Hair Transplant Breast Surgery Reduction Mammoplasty Mastopexy Breast Augmentation Implant Selection Fat Grafting to the Breast Breast Implant-Associated Anaplastic Large Cell Lymphoma Gynecomastia Abdominoplasty Body Contouring After Bariatric Surgery Liposuction Gender Affirmation Surgery Wound Management/Pressure Wounds Wounds Wound Healing Chronic Wounds Wound Assessment Diabetic Wound Peripheral Arterial Disease Venous Stasis and Ulcer Radiation Wound Infected Wound Pressure Injury Reconstruction of the Lower Extremity Soft Tissue Coverage of Traumatic Wounds Soft Tissue Reconstruction in the Groin and Thigh Soft Tissue Coverage of the Knee, Leg, and Foot Conclusion Selected References References 70 - Hand Surgery BASIC ANATOMY EXAMINATION AND DIAGNOSIS PRINCIPLES OF TREATMENT TRAUMA SELECTED REFERENCES REFERENCES 71 - Gynecologic Surgery External Reproductive Anatomy (Vulva) Internal Reproductive Anatomy (Vagina, Cervix, Uterus, Fallopian Tubes, Ovaries) Vagina Cervix Uterus Fallopian Tubes Ovaries Other Relevant Pelvic Anatomy Anatomic Spaces Vascular Structures Neurologic Structures Urinary Tract Structures Intestinal Tract Structures Common Vulvar and Vaginal Surgical Diseases Bartholin Gland Cyst or Abscess Vulva Intraepithelial Neoplasia Vulvar Cancer Vaginal Intraepithelial Neoplasia Vaginal Cancer Pelvic Organ Prolapse Common Vulva and Vaginal Surgical Procedures Incision and Drainage of Bartholin Gland Cyst or Abscess Marsupialization of Bartholin Gland Cyst or Abscess Wide Local Excision/Laser of the Vulva Laser of the Vagina/Partial Vaginectomy Radical Vulvectomy With Sentinel Node Mapping and Biopsy or Inguinal Femoral Lymphadenectomy Common Cervical Surgical Diseases Cervical Intraepithelial Neoplasia Cervical Cancer Common Cervical Surgical Techniques Conization/Loop Electrosurgical Excision Procedure Radical Hysterectomy/Radical Trachelectomy With Pelvic Lymphadenectomy Common Uterine Surgical Diseases Abnormal Uterine Bleeding Uterine Polyps Leiomyoma Adenomyosis Endometrial and Other Uterine Cancers Common Uterine Surgical Procedures Hysteroscopy, Dilation and Curettage, Endometrial Ablation Myomectomy Vaginal Myomectomy Hysteroscopic Myomectomy Laparoscopic and Open Myomectomy Hysterectomy Total Abdominal Hysterectomy Minimally Invasive Hysterectomy Vaginal Hysterectomy Supracervical Hysterectomy Elective Bilateral Salpingo-Oophorectomy and Opportunistic Salpingectomy Postoperative Cystoscopy after Hysterectomy Sentinel Node Biopsy and Lymphadenectomy for Endometrial Cancer Common Fallopian Tube/Ovarian Surgical Diseases BRCA Mutation Carrier Desires Sterilization Ectopic Pregnancy Torsion Endometrioma Benign Ovarian Masses Malignant Ovarian Neoplasms Common Fallopian Tube/Ovarian Surgical Procedures Tubal Sterilization Salpingectomy/Salpingostomy for Ectopic Pregnancy Ovarian Detorsion Ovarian Cystectomy Salpingo-Oophorectomy Fallopian Tube/Ovarian Cancer Cytoreduction Summary Selected References References 72 - Surgery in the Pregnant Patient PHYSIOLOGIC CHANGES OF PREGNANCY SAFETY CONCERNS IN PREGNANCY Radiologic Concerns Medication Concerns Analgesics Over-the-Counter Medications Prescription Medications Antibiotics Aminoglycosides Tetracyclines Metronidazole Penicillins Cephalosporins Lincosamide (Clindamycin) Macrolides (Azithromycin) Sulfonamide Derivatives Fluoroquinolones Other Gram Positive Agents Summary of Antibiotic Use Antithrombotic Agents Thrombotic Agents Anticoagulants Antiplatelet Agents Aspirin Clopidogrel Thrombolytic Agents Sedatives Benzodiazepines Anesthesia Concerns PREVENTION OF PRETERM LABOR MINIMALLY INVASIVE SURGERY IN PREGNANCY BREAST MASSES IN PREGNANCY Imaging and Biopsy During Pregnancy Pregnancy-Associated Breast Cancer SURGERY FOR DISEASES IN PREGNANCY Hepatobiliary Disease Cholelithiasis Endocrine Disease Adrenal Disease Thyroid Disease Small Bowel Disease Appendix, Colon, and Rectal Disease Vascular Disease TRAUMA IN PREGNANCY CONTROL OF MAJOR HEMORRHAGE Mechanical Hemorrhage Control Surgical Ligation Resuscitative Endovascular Balloon Occlusion of the Aorta Intrauterine Balloon Tamponade Adjuncts for Major Hemorrhage Cell Salvage Damage Control Techniques Benign Disease Bariatric Surgery Ileal Pouch–Anal Anastomosis Malignant Disease SUMMARY SELECTED REFERENCES Anchor 380 REFERENCES 73 - Fetal Surgery The Birth of a New Surgical Specialty Maternal Considerations and Morbidity Fetal Surgery by System Neurologic System Myelomeningocele or Spina Bifida Sacrococcygeal Teratoma Neck/Chest Cervical Teratoma Ex Utero Intrapartum Treatment Procedure Congenital Lung Lesions Congenital Diaphragmatic Hernia Cardiac Congenital Cardiac Lesions Twin-Twin Transfusion Syndrome Abdomen Gastroschisis Genitourinary Lower Urinary Tract Obstruction In Utero Stem Cell Transplantation Fetal Tissue Engineering In Utero Gene Therapy Artificial Placenta Acknowledgements Selected References References 74 - Urologic Surgery Urologic Anatomy for the General Surgeon Upper Abdomen and Retroperitoneum Adrenal Kidney Ureter Pelvis Bladder and Prostate Urethra, Male Genitalia, and Perineum Endoscopic Urologic Surgery Urologic Infectious Disease Uncomplicated Urinary Tract Infection Premenopausal Patients Postmenopausal Patients Complicated Urinary Tract Infection Urinary Tract Infection in Men Specific Complicated Genitourinary Infectious States Pyelonephritis Male Genital Organ Infection Fournier Gangrene Atypical Urinary Tract Infections Fungal Infection Tuberculosis Parasitic Infection Neurogenic Bladder Urinary Incontinence Benign Prostatic Hyperplasia Basic Laboratory Assessment Treatment Male Sexual Dysfunction and Treatment Urolithiasis Background Acute Presentation and Management Elective Diagnostic Evaluation and Management Elective Surgical Management Urologic Trauma Renal Injuries Imaging Management: Operative Versus Nonoperative Surgical Exploration and Operative Approach Ureteral Injuries Imaging Management Surgical Exploration and Operative Approach Bladder Injuries Imaging Management: Operative Versus Nonoperative Surgical Exploration and Operative Approach Urethral Injuries Imaging Management Surgical Exploration and Operative Approach Genital Injuries Imaging Management Damage Control Techniques for Urologic Injuries Nontraumatic Urologic Emergencies Testicular Torsion Priapism Urologic Oncology Renal Cancer Staging Management Bladder Cancer Nonmuscle Invasive Bladder Cancer Muscle Invasive Bladder Cancer Prostate Cancer Evaluation Treatment Testicular Cancer Treatment Selected References References INDEX A B C D E F G H I J K L M N O P Q R S T U V W X Y Z IBC