William P. Longmire, Jr., M.D.. Advisor for Editorial Board. Los Angeles, Califomia. H. Kim Lyerly, M.D.. Advisor for Residents in Surgery. Durham, North Carolina.
ANNALS OF SURGERY jo
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William P. Longmire, Jr., M.D. Advisor for Editorial Board Los Angeles, Califomia H. Kim Lyerly, M.D. Advisor for Residents in Surgery Durham, North Carolina
Essentials of Surgery, 2nd Edition David C. Sabiston, Jr., and H. Kim Lyerly, 774 pp. Philadelphia: W. B. Saunders Company, 1994, $34.95. The challenge for editors of any surgical textbook is to clearly define the goals of the work, identify the target audience, and present the material in an orderly, concise manner. Drs. Sabiston and Lyerly have been enormously successful in meeting these editorial responsibilities. They have brought together a diverse group of wellrespected surgical scholars and have focused their efforts in such a way that a masterful, concise, yet thoroughly complete book specifically designed for medical students experiencing their surgical rotations, is the final product. This book is easy to read (and perhaps more importantly, easy to carry) and will undoubtedly become a cherished resource for students throughout the country. We all hope that our students will be familiar with appropriate basic science issues relative and pertinent to the important clinical problems that we, as surgical clinicians, deal with on a day-to-day basis. We also anticipate and hope that they will have a certain level of understanding and awareness of the critical nature of these surgical problems, and the rationale for their evaluation and treatment. As surgical educators, we all probably have been guilty of overwhelming our young people with too much information that is not essential to their education. Learning is facilitated by providing appropriate information in a package that can be assimilated easily. Drs. Sabiston and Lyerly have accomplished this in a wonderful book, this, the second edition of Essentials of
Slurgery. Essentials of Surgery is composed of 49 chapters covering 774 pages. The format of the book and distribution of chapters essentially is identical to the major text, Textbook ofSurgery, the Biological Basis ofModern Surgical Practice. However, it is not intended to be the definitive text for the surgical discipline, and it is not intended to be an encyclopedia. The similar format makes it easy for students to refer to the more comprehensive text to address specific questions. I view this to be a major plus of
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the abridged version, and believe it greatly adds to the value of this work. All aspects of surgery in general are covered in Essentials of Surgery, including chapters on the body's response to trauma and surgical stress, shock, issues related to fluid and electrolyte management, hematologic and nutritional factors, anesthesia, and wound healing. General surgery topics and the surgical specialties also are reviewed in Essentials of Surgery. This book is up-to-date and has some very interesting chapters dealing with extracorporeal membrane oxygenation, surgical aspects of the acquired immunodeficiency syndrome, and the molecular biologic basis of cancer. These are state-of-the-art issues, and obviously are of great current concern and areas of investigation. I believe that the second edition of Essentials of Surgery will be as well received as the first volume was and will become the "go to" book for many generations of students rotating through their surgical clerkships. This book undoubtedly will prove to be a marvelous resource for students and should provide them with the fundamental information that is required for a sound understanding ofthe scientific bases for surgical decision making and intervention. Drs. Sabiston and Lyerly have done all of us a great service, and I personally wish to thank them for helping us educate the next generation of
physicians. JOEL J. ROSLYN, M.D.
Philadelphia, Pennsylvania Complications of Trauma Kenneth L. Mattox, 687 pp. New York: Churchill Livingstone, 1994, $139.95. Complications of Trauma is a comprehensive, wellwritten book that successfully achieves Dr. Mattox's goal of creating a text that focuses on the complications encountered in treating the trauma victim. It does not attempt to concentrate on causes, diagnostic workup, and management of specific traumatic injuries, although some overlap is inevitable when one considers the multitude and complexity of potential complications that may occur in the injured patient. The book is organized into four sections that contain chapters written by notable contributors in the field of trauma. The first section addresses what Dr. Mattox refers to as the "big five" complications-hemorrhage, respiratory failure, renal failure, sepsis, and multi-organ 705
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Book Reviews
failure. These chapters provide interesting historical perspectives and pertinent discussions of the pathophysiology, prevention, recognition, and treatment of these frequently seen complications. The second section contains three excellent chapters on pre-hospital and emergency center complications. The chapter on complications of resuscitation particularly is noteworthy for its thorough, well-illustrated treatment of the important topic of airway management problems; however, some of the information is duplicated in a later chapter on airway complications. The third section includes discussions relating to general complications after trauma. The chapters on medication-related complications, wound healing complications, economic complications, and complications of wound agents are especially outstanding. The discussions on anesthesia and radiology-related complications seem a bit superficial. The last section, which addresses complications by anatomic region, contains 18 chapters that are generally superb, complete, and nicely illustrated. Complications of Trauma is an excellent book that should be an essential addition to the libraries ofsurgical residents, general surgeons who occasionally treat injured patients, and dedicated trauma specialists. It is an important volume that complements any of a number of existing books that deal with the management of trauma. STEVEN N. VASLEF, M.D., PH.D. Evanston, Illinois
Surgery for Stroke R. M. Greenhalgh and L. H. Hollier, 420 pp. Philadelphia: W. B. Saunders Company, 1993, $135.00. The title of this book is somewhat misleading. The breadth of the book is limited to topics pertinent to the carotid bifurcation. The book does not discuss topics related to the innominate, subclavian, and vertebral arteries; it does not cover strokes caused by diseases of the proximal or distal carotid arteries. Furthermore, other disease processes, such as fibromuscular dysplasia, hemorrhagic strokes, and lacunar strokes, are not discussed. The chapters and sections are presented in a somewhat random fashion and could be better organized. For example, the Natural History and the Clinical Trials sections appear at the end of the book and should appear earlier next to the Indications for Carotid Surgery section. The Timing of Carotid Surgery section, consisting of only two chapters, should be deleted, and its two chapters should be incorporated elsewhere. Specifically, the chapter entitled Cerebral Oximetry in Carotid Endarterectomy and Acute Stroke would fit better in the Intraoperative Monitoring or the Pathophysiological Aspects
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sections; the chapter entitled Emergency Carotid Surgery with Positive Computed Tomographic Scan should be moved to the Pathophysiological Aspects section or deleted entirely because this chapter is only a brief discussion of four patients. Some of the sections should be expanded and made more comprehensive. For example, the Pathophysiological Aspects section could include additional chapters on cerebral reperfusion, postoperative hypertension, and cerebral vasomotor dysautoregulation. The Intraoperative Monitoring section could include additional chapters on electroencephalogram, brain mapping, spectral analysis, and carotid back-pressure measurements. The best sections are the Techniques of Carotid Surgery section and the Clinical Trials section. The chapters in these sections are comprehensive, uniformly well written, well illustrated, and up to date. However, the chapter entitled Preservation ofCarotid Flow in Carotid Body Tumour Surgery seems out of place in a book otherwise devoted to carotid endarterectomy. A completely new section entitled Pharmacological and Adjunctive Therapies should be created to incorporate the chapters The Influence of Smoking and Lipids on Restenosis After Carotid Endarterectomy and Antiplatelet or Anticoagulant Therapy After Carotid Endarterectomy. Additional new chapters discussing angiotensin-converting enzyme inhibitors, steroids, and control of risk factors, such as hypertension and diabetes, could be added to this new section. Overall, this book provides some well written, well illustrated chapters on carotid endarterectomy for the prevention and treatment of stroke. However, these chapters are organized poorly, and some are weak (e.g., the chapter entitled Duplex Scanning provides only a cursory review). Furthermore, some of the sections are not comprehensive, and the book itself does not meet the goals implied by the title. In due respect to the editors, who are extremely well qualified, this book represents one oftheir weaker efforts. SAMUEL S. AHN, M.D. Los Angeles, California
Vascular Surgery: Principles and Practice, 2nd Edition Frank J. Veith, Robert W. Hobson, Russell A. Williams, and Samuel E. Wilson, 1250 pp. New York: McGraw-Hill, 1994, $175.00. In its second edition, Vascular Surgery: Principles and Practice remains a practical text for the surgeon caring for patients with vascular diseases. The editors also propose that their book serves as a resource volume for prac-
