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Medical Management of the Surgical Patient: A Textbook of Perioperative Medicine

Medical Management of the Surgical Patient: A Textbook of Perioperative Medicine Edited by Michael F. Lubin, Robert B. Smith III, Thomas F. Dodson, Nathan O. Spell, and H. Kenneth Walker, 4th ed, 813 pp, $150. New York, NY, Cambridge University Press, 2006. ISBN-13 978-0-521-82800-0. To know what you know and to know what you do not know is knowledge.—Henry David Thoreau Medical Management of the Surgical Patient is a text for diagnosticians who endeavor to serve in the perioperative period. Its clarity will prove valuable in the diagnosis and treatment of subtle conditions and disorders, along with potentially fatal conditions, such as postoperative acute myocardial infarction. Editor Michael F. Lubin, MD, of Emory University, provides the paradigm of perioperative consultation in his chapter “Surgery in the Elderly” when he addresses why the diagnosis of appendicitis in the elderly is missed: “Because it is never considered!” The text is full of practical, specific recommendations typically supported by citations of published studies. For instance, adequate nursing staffing in postoperative care areas is cited as important in reducing the likelihood of postoperative pulmonary complications—underscoring the team approach to perioperative care. Regarding anemia, rather than simple transfusion of red blood cells, thorough diagnostic workups should be performed. As validation of tight control of diabetes, intravenous insulin is recommended to effectively reduce the incidence of sternal wound infections. An entire chapter is devoted to the “Medical Care of the HIV-Infected Surgical Patient.” Other practical chapters consider substance abuse, thyroidectomy, and splenectomy. Emblematic of the text's specific advice is the recommendation on treating hypokalemia in the chapter “Coronary Artery Bypass Procedures.” We learn in the chapter “Ventricular Assist Devices and Cardiac Transplantation” that, on average, patients experience “1.3 rejection episodes in the first year.” The authors of the chapter on carotid endarterectomy note that the procedure aimed at preventing stroke, “has a recognized “stroke” complication rate of 2%.” The difficulties of when to recommend elective aneurysmectomy are discussed in the chapter “Abdominal Aortic Aneurysm Repair.” The authors of the chapter on “Lower Extremity Amputations” assert that treatment of “non-painful awareness of the amputated limb” is “unnecessary.” New to me is that superior vena cava syndrome is viewed as an oncology urgency, but not emergency, and necessitates prompt histopathologic diagnosis as a guide to timely and appropriate treatment. The chapters flow smoothly through the perioperative care of virtually all organs and organ systems. Emphasis is placed on the challenges presented by somewhat occult conditions and disorders, such as pheochromocytoma in pregnancy. This text tells it like it is; for example, when a condition such as sickle cell disease has no clear perioperative management, this text frankly states so. Worrisome issues, such as occupational transmission of HIV, and such crises as delirium in the perioperative period, are also forthrightly considered. As a diagnostician, my most gratifying work has been consultation-liaison with my colleagues in the surgical specialties. To facilitate such consultation, I recommend that this text be available in all medical school libraries. I also recommend it for medical students and medical and surgical house officers. Medical Management of the Surgical Patient also belongs in the personal libraries of all clinicians who provide perioperative consultations. Back to top Article Information Financial Disclosures: None reported. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Medical Management of the Surgical Patient: A Textbook of Perioperative Medicine

Grossman, Joshua
JAMA , Volume 297 (12) – Mar 28, 2007
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Medical Management of the Surgical Patient: A Textbook of Perioperative Medicine

Abstract

Edited by Michael F. Lubin, Robert B. Smith III, Thomas F. Dodson, Nathan O. Spell, and H. Kenneth Walker, 4th ed, 813 pp, $150. New York, NY, Cambridge University Press, 2006. ISBN-13 978-0-521-82800-0. To know what you know and to know what you do not know is knowledge.—Henry David Thoreau Medical Management of the Surgical Patient is a text for diagnosticians who endeavor to serve in the perioperative period. Its clarity will prove valuable in the diagnosis and treatment of subtle...
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Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.297.12.1379-a
Publisher site
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Abstract

Edited by Michael F. Lubin, Robert B. Smith III, Thomas F. Dodson, Nathan O. Spell, and H. Kenneth Walker, 4th ed, 813 pp, $150. New York, NY, Cambridge University Press, 2006. ISBN-13 978-0-521-82800-0. To know what you know and to know what you do not know is knowledge.—Henry David Thoreau Medical Management of the Surgical Patient is a text for diagnosticians who endeavor to serve in the perioperative period. Its clarity will prove valuable in the diagnosis and treatment of subtle conditions and disorders, along with potentially fatal conditions, such as postoperative acute myocardial infarction. Editor Michael F. Lubin, MD, of Emory University, provides the paradigm of perioperative consultation in his chapter “Surgery in the Elderly” when he addresses why the diagnosis of appendicitis in the elderly is missed: “Because it is never considered!” The text is full of practical, specific recommendations typically supported by citations of published studies. For instance, adequate nursing staffing in postoperative care areas is cited as important in reducing the likelihood of postoperative pulmonary complications—underscoring the team approach to perioperative care. Regarding anemia, rather than simple transfusion of red blood cells, thorough diagnostic workups should be performed. As validation of tight control of diabetes, intravenous insulin is recommended to effectively reduce the incidence of sternal wound infections. An entire chapter is devoted to the “Medical Care of the HIV-Infected Surgical Patient.” Other practical chapters consider substance abuse, thyroidectomy, and splenectomy. Emblematic of the text's specific advice is the recommendation on treating hypokalemia in the chapter “Coronary Artery Bypass Procedures.” We learn in the chapter “Ventricular Assist Devices and Cardiac Transplantation” that, on average, patients experience “1.3 rejection episodes in the first year.” The authors of the chapter on carotid endarterectomy note that the procedure aimed at preventing stroke, “has a recognized “stroke” complication rate of 2%.” The difficulties of when to recommend elective aneurysmectomy are discussed in the chapter “Abdominal Aortic Aneurysm Repair.” The authors of the chapter on “Lower Extremity Amputations” assert that treatment of “non-painful awareness of the amputated limb” is “unnecessary.” New to me is that superior vena cava syndrome is viewed as an oncology urgency, but not emergency, and necessitates prompt histopathologic diagnosis as a guide to timely and appropriate treatment. The chapters flow smoothly through the perioperative care of virtually all organs and organ systems. Emphasis is placed on the challenges presented by somewhat occult conditions and disorders, such as pheochromocytoma in pregnancy. This text tells it like it is; for example, when a condition such as sickle cell disease has no clear perioperative management, this text frankly states so. Worrisome issues, such as occupational transmission of HIV, and such crises as delirium in the perioperative period, are also forthrightly considered. As a diagnostician, my most gratifying work has been consultation-liaison with my colleagues in the surgical specialties. To facilitate such consultation, I recommend that this text be available in all medical school libraries. I also recommend it for medical students and medical and surgical house officers. Medical Management of the Surgical Patient also belongs in the personal libraries of all clinicians who provide perioperative consultations. Back to top Article Information Financial Disclosures: None reported.

Journal

JAMA – American Medical Association

Published: Mar 28, 2007

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