Surgical Decision Making, 6e

Description

Using a proven, practical, algorithmic approach, Surgical Decision Making summarizes evidence-based guidelines and practice protocols in an easy-to-follow format. Designed to sharpen the decision-making skills of both trainees and practicing surgeons, the 6th Edition directs your focus to the critical decision points in a wide range of clinical scenarios, helping you determine optimal evaluation and management to secure the best possible patient outcomes. Algorithms are accompanied by annotations that explain all critical factors affecting decisions in a concise, readable manner. Reflects the scope of practice of today's general surgeon, with fresh, expert perspectives from new editor Dr. Richard Schulick and numerous new contributors.Contains 58 new chapters and thoroughly revised content throughout.Includes new coverage of Preoperative Evaluation of the Geriatric Patient, Pancreatic Cystic Neoplasm, Familial Breast Cancer, Resuscitative Endovascular Balloon Occlusion of the Aorta, Blunt Cerebrovascular Injury, and much more.Uses an easy-to-follow, consistent format, with an algorithm on one page and short descriptions explaining the various steps in the decision-making process on the opposite page.Includes explanatory notes that summarize presenting signs and symptoms, laboratory investigation, diagnostic modalities, surgical therapies, and adjuvant therapies for each condition.Encompasses both general surgery and surgical subspecialties?helping you directly manage a broad range of problems. Emphasizes information that frequently appears on board exams.Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices. Cover Surgical Decision Making Copyright Page Dedication Contributors Preface 1 Preoperative Laboratory Evaluation Abstract Keywords References 2 Preoperative Cardiac Evaluation Abstract Keywords References 3 Preoperative Pulmonary Evaluation Abstract Keywords Conclusions References 4 Bleeding Disorders in Surgical Patients Abstract Keywords References 5 Hypercoagulable Patient Abstract Keywords References 6 Postoperative Fever Abstract Keywords References 7 Bridge Anticoagulation Abstract Keywords References 8 Intraabdominal Infection Abstract Keywords References 9 Preoperative Evaluation of the Geriatric Patient Abstract Keywords Geriatric Patients Establishing Advance Directives Preoperative High-Risk Screening Patient-Centered Operative Decision Making Tailoring of Surgical Recommendations Preoperative Optimization References 10 Cardiopulmonary Resuscitation Abstract Keywords References 11 Perioperative Arrhythmia Abstract Keywords History and Physical Preoperative Evaluation and Testing Cardiovascular Implantable Electronic Device (CIED) Tachyarrhythmias Bradyarrhythmias References 12 Perioperative Myocardial Ischemia and Infarction Abstract Keywords References 13 Shock Abstract Keywords Introduction References 14 Goal-Directed Resuscitation Abstract Keywords References 15 Pulmonary Embolism Abstract Keywords References 16 Ventilator- Associated Pneumonia Abstract Keywords References 17 Nutritional Support Abstract Keywords References 18 Acute Respiratory Failure Abstract Keywords Noninvasive Ventilation Invasive Mechanical Ventilation Systemic and Hemodynamic Treatment Sedation and Pain Control Protocolized Ventilator Weaning Consider Extubation Tracheostomy Acute Respiratory Distress Syndrome Low-Tidal-Volume Ventilation High-PEEP Open Lung Strategy Restrictive Fluid Strategy Neuromuscular Blockade Inhaled Nitric Oxide Prone Position Recruitment Maneuvers Esophageal Pressure, High-Frequency Oscillatory Ventilation, and Airway Pressure-Release Ventilation Extracorporeal Membrane Oxygenation References 19 Acute Hypoxic Event Abstract Keywords References 20 Acute Renal Failure Abstract Keywords Introduction Conclusions References 21 Acid–Base Disorders Abstract Keywords References 22 Sodium Disorders Abstract Keywords Introduction Conclusion References 23 Potassium Disorders Abstract Keywords Hypokalemia References 24 Calcium Disorders Abstract Keywords References 25 Hypothermia Abstract Keywords References 26 Neck Mass Abstract Keywords References 27 Nonmelanoma Skin Cancer of the Face Abstract Keywords References 28 Management of Melanoma of the Head and Neck Abstract Keywords Suspicious Cutaneous Lesions of the Head and Neck Biopsy Palpable Mass in the Parotid Gland or Neck in Patient With Cutaneous Melanoma Benign Lesions Premalignant Lesion Early-Stage Melanoma—Tis and T1 Invasive Melanoma > 1 mm Thick Positive FNAB Negative FNAB Nondiagnostic FNAB Sentinel Lymph Node Biopsy Sentinel Node Negative Positive Sentinel Node References 29 Lung Nodule Abstract Keywords References 30 Mediastinal Tumors Abstract Keywords Introduction References 31 Pleural Effusion and Empyema Abstract Keywords References 32 Achalasia Abstract Keywords References 33 Esophageal Motility Disorders (Other Than Achalasia) Abstract Keywords References 34 Esophageal Perforation Abstract Keywords References 35 Caustic Ingestion Abstract Keywords References 36 Gastroesophageal Reflux Disease Abstract Keywords References 37 Barrett’s Esophagus Abstract Keywords References 38 Esophageal Diverticulum Abstract Keywords References 39 Paraesophageal Hiatal Hernia Abstract Keywords Initial Assessment Surgical Management References 40 Gastric Ulcer Abstract Keywords References 41 Duodenal Ulcer Abstract Keywords References 42 Morbid Obesity Abstract Keywords References 43 Upper GI Bleeding Abstract Keywords References 44 Bleeding Esophageal Varices Abstract Keywords References 45 Jaundice Abstract Keywords References 46 Obstructive Jaundice Abstract Keywords References 47 Cholelithiasis Abstract Keywords References 48 Choledocholithiasis Abstract Keywords References 49 Hepatic Abscess Abstract Keywords References 50 Cystic Liver Disease Abstract Keywords References 51 Solid Liver Lesion Abstract Keywords References 52 Acute Pancreatitis Abstract Keywords References 53 Chronic Pancreatitis Abstract Keywords References 54 Pancreatic Pseudocysts Abstract Keywords References 55 Pancreas Divisum Abstract Keywords History and Physical Examination Differential Diagnosis Physical Findings, Imaging, and Labs Endoscopic Retrograde Cholangiopancreatography Magnetic Resonance Pancreatography Secretin-Stimulated Ultrasonography Pancreatic Divisum Classifications Asymptomatic/Incidental Finding Symptomatic Mild Symptoms Without Pancreatitis Severe Acute Pancreatitis and Abdominal Pain Medical Treatment for Pancreatitis Chronic Pancreatitis and Abdominal Pain Treatment: Endoscopic Approach Primary Treatment Option— the Endoscopic Approach Endoscopic Dilation of the Minor Papilla (an Alternative to EMPS) Treatment: Surgical Minor Duct Sphincteroplasty Postprocedure Management ERCP Postprocedure Management Surgical Postoperative Management Other Complications References 56 Small Bowel Obstruction Abstract Keywords Introduction References 57 Acute Mesenteric Vascular Occlusion Abstract Keywords References 58 Short Bowel Syndrome Abstract Keywords References 59 Enterocutaneous Fistula Abstract Keywords References 60 Crohn’s Disease of the Small Bowel Abstract Keywords References 61 Right Lower Quadrant Pain Abstract Keywords References 62 Volvulus Abstract Keywords References 63 Diverticulitis Abstract Keyword References 64 Lower Gastrointestinal Bleeding Abstract Keywords References 65 Ulcerative Colitis Abstract Keywords References 66 Ischemic Colitis Abstract Keyword Introduction References 67 Toxic Megacolon Abstract Keywords References 68 C. dif Colitis Abstract Keywords References 69 Large Bowel Obstruction Abstract Keywords References 70 Rectal Prolapse Abstract Keywords References 71 Constipation Abstract Keywords Introduction References 72 Appendicitis Abstract Keywords References 73 Anorectal Abscess and Fistula-in-Ano Abstract Keywords References 74 Hemorrhoids Abstract Keywords References 75 Pilonidal Disease Abstract Keywords References 76 Anal Fissure Abstract Keywords References 77 Groin Hernia Abstract Keywords References 78 Ventral Hernia Abstract Keywords References 79 Cancer of Unknown Primary Abstract Keywords References 80 Esophageal Cancer Abstract Keywords References 81 Gastric Cancer Abstract Keywords References 82 Cholangiocarcinoma Abstract Keywords References 83 Hepatocellular Carcinoma Abstract Keywords References 84 Gallbladder Carcinoma Abstract Keywords References 85 Gastrointestinal Stromal Tumors (GISTs) Abstract Keywords References 86 Pancreatic Neuroendocrine Tumors Abstract Keywords References 87 Periampullary Carcinoma Abstract Keywords References 88 Pancreatic Cystic Neoplasms Abstract Keywords References 89 Pancreatic Mass Abstract Keywords References 90 Retroperitoneal Mass Abstract Keywords References 91 GI Lymphoma Abstract Keywords Introduction References 92 Colon Polyp Abstract Keywords References 93 Colon Cancer Abstract Keywords References 94 Rectal Cancer Abstract Keywords References 95 Anal Cancer Abstract Keywords References 96 Metastatic Colorectal Carcinoma Abstract Keywords References 97 Breast and Soft Tissues Abstract Keywords References 98 Gynecomastia Abstract Keywords References 99 Palpable Breast Mass Abstract Keywords References 100 Nonpalpable Breast Lesions Abstract Keywords References 101 Early Breast Cancer Abstract Keywords References 102 Advanced Breast Cancer Abstract Keywords References 103 Recurrent Breast Carcinoma Abstract Keywords References 104 Familial Breast Cancer Abstract Keywords Hereditary Breast and Ovarian Cancer Syndrome Testing Criteria Cancer Genetics in the Era of Multigene Testing Clinical Guidelines for Patients With a Known Genetic Predisposition to Breast Cancer References 105 Breast Reconstruction Abstract Keywords References 106 Soft Tissue Masses of the Extremities Abstract Keywords Introduction Clinical Assessment Biopsy and Imaging Staging Tumor Biology Determines Resectability and Management Resectable High-Risk Anatomy High-Risk Biology Unresectable References 107 Cutaneous Melanoma Abstract Keywords References 108 Nonmelanoma Skin Cancer Abstract Keywords References 109 Thyrotoxicosis Abstract Keywords References 110 Thyroid Nodule Abstract Keywords Introduction References 111 Well- Differentiated Thyroid Cancer Abstract Keywords References 112 Medullary Thyroid Carcinoma Abstract Keyword References 113 Hypercalcemia and Hyperparathyroidism Abstract Keywords References 114 Hypoglycemia and Insulinoma Abstract Keywords References 116 Adrenal Incidentaloma Abstract Keyword References 115 Zollinger-Ellison Syndrome Abstract Keywords References 117 Pheochromocytoma Abstract Keywords References 118 Cushing’s Syndrome Abstract Keywords References 119 Primary Aldosteronism Abstract Keywords References 120 Initial Evaluation and Resuscitation Abstract Keywords Primary Survey Adjuncts Assess Need for Resuscitation Secondary Survey Begin Resuscitation Control Hemorrhage Restore Blood Oxygen-Carrying Capacity and Correct Coagulopathy Serial COMPLETE BLOOD COUNTS Serial THROMBOELASTOGRAMS Correct Metabolic Derangements Reassessment References 121 Airway Management Abstract Keywords References 122 Cervical Spine Injury Abstract Keywords Introduction References 123 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Abstract Keywords References 124 Emergency Department Thoracotomy Abstract Keywords References 125 Penetrating Neck Trauma Abstract Keywords References 126 Blunt Cerebrovascular Injury Abstract Keywords References 127 Rib Fractures Abstract Keywords References 128 Hemo- Pneumothorax Abstract Keywords References 129 Blunt Thoracic Aortic Injury Abstract Keyword Introduction Mechanism of Injury Diagnostic Imaging—CTA Chest Grading of Injury Medical Management of Grade I Injuries Semi-Elective TEVAR for Grade II or III Injuries Emergency TEVAR for Grade IV Injuries Coverage of Left Subclavian Artery Management Follow-Up Imaging References 130 Blunt Cardiac Injury Abstract Keywords References 131 Annotations to Thoracoabdominal Trauma Abstract Keywords References 132 Blunt Abdominal Trauma Abstract Keywords References 133 Penetrating Abdominal Injury Abstract Keywords References 134 Blunt Splenic Injury Abstract Keywords References 135 Liver Injury Abstract Keywords References 136 Abdominal Vascular Injuries Abstract Keywords References 137 Pancreatic Injury Abstract Keywords References 138 Duodenal Injury Abstract Keywords References 139 Penetrating Injury of the Colon Abstract Keywords References 140 Penetrating Rectal Injury Abstract Keywords References 141 Damage-Control Laparotomy Abstract Keywords References 142 Abdominal Compartment Syndrome Abstract Keywords References 143 Traumatic Hematuria Abstract Keywords References 144 Renal Injury Abstract Keywords References 145 Ureteral Injuries Abstract Keywords References 146 Bladder and Urethral Trauma Abstract Keywords References 147 Pelvic Fractures Abstract Keywords References 148 Closed Head Injury Abstract Keywords References 149 Cervical Spine Fractures Abstract Keywords Cervical Spine Precautions Localization Fracture Anatomy Vascular Imaging Neurologic Status Stability Disposition References 150 Spinal Cord Injury Abstract Keywords Introduction Special Considerations Conclusion References 151 Popliteal Artery Injury Abstract Keywords References 152 Burns Abstract Keywords References 153 Acute Frostbite Abstract Keywords Prehospital or Emergency Department Management Rapid External Rewarming Thrombolytic Therapy Contraindications to the Thrombolytic Protocol Post-Rewarming Management References 154 Electrical Burn Injury Abstract Keywords Potential Complications After Electrical Injury References