BookBenjamin J. Hazen, Shishir K. Maithel, Ravi R. Rajani, Jahnavi Srinivasan, editors.
Summary: Comprehensive and high-yield, this text is a digestible resource for the major anatomic, physiologic, and therapeutic principles of surgical diseases. Rather than focus on clinical presentation and pre-operative management, it presents sensible algorithmic approaches to treatment for each pathology, with particular attention to operative options. This allows the reader to develop a large armamentarium of surgical options to safely treat surgical problems and aid in the decision-making process in an organized fashion, with critical steps and techniques of specific operations included in each chapter. Importantly, this book provides a concise list of steps for common surgical operations, namely those frequently encountered during the Certifying Oral Board exam after completing residency, which is uncommon in the currently available study material. Chapters also include suggested readings and summaries of pivotal studies on the specific topics, serving as an easy reference for the content provided. The topics covered begin with pre-operative evaluation and anesthesiology, then proceed anatomically across all relevant body systems and organs, as well as trauma, transplantation, pediatric surgery, and much more. Written with senior-level general surgery residents preparing for the qualifying (written) and certifying (oral) board examinations clearly in mind, it will also be valuable to all levels of trainees preparing for the annual American Board of Surgery In-service Training Exam (ABSITE) as well as medical students with an interest in surgical training and trainees in their fellowship after completing residency.
Contents:
Intro
Foreword
Preface
Contents
Editors and Contributors
Editors
Associate Editors
Contributors
1: Pre-operative Evaluation and Management
ASA Physical Status
Significance of ASA Physical Status
Determination of ASA Physical Status
Preoperative Fasting Guidelines
Selection and Timing of Preoperative Tests
Echocardiography, Stress Testing, and Cardiac Catheterization Before Surgery
Stratification of Low, Intermediate, and High-Risk Surgical Procedures
Risk Factors for Perioperative Adverse Cardiac Event
Assessment of Exercise Tolerance Perioperative Medication Management
Special Considerations for Cardiac Implantable Electronic Devices (CIEDs)
Electrocautery and CIED Safety
Special Considerations for Patients with Obstructive Sleep Apnea (OSA)
References
2: Anesthesiology
Anesthesia Providers
Anesthetic Technique
General Anesthesia
Monitored Anesthesia Care (MAC) [1]
Moderate Sedation
Regional Anesthesia
Monitors [2]
Standard ASA monitors
Hemodynamic Monitoring
Neuromonitoring
Pharmacology
Inhalational Anesthetics (Nitrous Oxide, Isoflurane, Sevoflurane, Desflurane) Intravenous Anesthetics
Propofol [2]
Barbiturates: Thiopental, Methohexital, Pentobarbital [2]
Benzodiazepines (Midazolam, Diazepam, Lorazepam) [2]
Phencyclidines (Ketamine) [2]
Etomidate [2]
Dexmedetomidine [2, 3]
Local Anesthetics [2]
Opioids
Non-Opioid Analgesics [4]
Neuromuscular Blockers
Depolarizing: Succinylcholine (only agent in clinical use) [2]
Non-Depolarizing
Postoperative Nausea and Vomiting (PONV) [5, 6]
Airway Management
Bag Valve Mask (BVM) Ventilation ("Bag Masking") [4]
Supraglottic Airways (SGA) [4] Intubation and Specialized Endotrachial Tubes (ETT)
RSI (Rapid Sequence Induction) [4]
Difficult Airway [4, 7]
Extubation [4]
PACU Discharge Criteria [5]
References
3: Nutrition
Introduction
Anatomy
Small Intestine
Large Intestine
Physiology
Fat Digestion
Carbohydrate Digestion
Protein Digestion
Enteral vs. Parenteral Nutrition
Enteral: Tube Feeds
Parenteral: PPN vs TPN
Calculating TPN (Fig. 3.2)
Malnutrition
Short Bowel Syndrome (SBS)
Refeeding Syndrome
Permissive Underfeeding: 15-20 kcal/kg/day
Overfeeding TPN-Associated Liver Abnormalities
Transitional Feeding: TPN to Enteral Nutrition
Calculations (Fig. 3.4)
Surgical Options for Enteral Access
PEG (Percutaneous Endoscopic Gastrostomy): Three Approaches [5]
"Pull:" (Most Common)
"Push:" (Often Used by Radiologists, Under Fluoroscopy)
Introducer
Laparoscopic Gastrostomy Tube [6]
References
4: Hematology/Blood Products
Coagulation Cascade (Fig. 4.1)
Thromboelastography
Initiating or Resuming Anticoagulation
Thrombolytics
Hypocoagulable States
Heparin-Induced Thrombocytopenia
Etiology
Types