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Oxford Handbook of Clinical Surgery Published and Forthcoming Oxford Handbooks OXFORD MEDICAL PUBLICATIONS Oxford Handbook of Clinical Surgery Published and forthcoming Oxford Handbooks Oxford Handbook for the Foundation Programme 3e Oxford Handbook of Acute Medicine 3e Oxford Handbook of Anaesthesia 3e Oxford Handbook of Applied Dental Sciences Oxford Handbook of Cardiology 2e Oxford Handbook of Clinical and Laboratory Investigation 3e Oxford Handbook of Clinical Dentistry 5e Oxford Handbook of Clinical Diagnosis 2e Oxford Handbook of Clinical Examination and Practical Skills Oxford Handbook of Clinical Haematology 3e Oxford Handbook of Clinical Immunology and Allergy 3e Oxford Handbook of Clinical Medicine – Mini Edition 8e Oxford Handbook of Clinical Medicine 8e Oxford Handbook of Clinical Pathology Oxford Handbook of Clinical Pharmacy 2e Oxford Handbook of Clinical Rehabilitation 2e Oxford Handbook of Clinical Specialties 9e Oxford Handbook of Clinical Surgery 4e Oxford Handbook of Complementary Medicine Oxford Handbook of Critical Care 3e Oxford Handbook of Dental Patient Care 2e Oxford Handbook of Dialysis 3e Oxford Handbook of Emergency Medicine 4e Oxford Handbook of Endocrinology and Diabetes 2e Oxford Handbook of ENT and Head and Neck Surgery Oxford Handbook of Epidemiology for Clinicians Oxford Handbook of Expedition and Wilderness Medicine Oxford Handbook of Gastroenterology & Hepatology 2e Oxford Handbook of General Practice 3e Oxford Handbook of Genetics Oxford Handbook of Genitourinary Medicine, HIV and AIDS 2e Oxford Handbook of Geriatric Medicine Oxford Handbook of Infectious Diseases and Microbiology Oxford Handbook of Key Clinical Evidence Oxford Handbook of Medical Dermatology Oxford Handbook of Medical Imaging Oxford Handbook of Medical Sciences 2e Oxford Handbook of Medical Statistics Oxford Handbook of Nephrology and Hypertension Oxford Handbook of Neurology Oxford Handbook of Nutrition and Dietetics 2e Oxford Handbook of Obstetrics and Gynaecology 2e Oxford Handbook of Occupational Health 2e Oxford Handbook of Oncology 3e Oxford Handbook of Ophthalmology 2e Oxford Handbook of Oral and Maxillofacial Surgery Oxford Handbook of Paediatrics 2e Oxford Handbook of Pain Management Oxford Handbook of Palliative Care 2e Oxford Handbook of Practical Drug Therapy 2e Oxford Handbook of Pre-Hospital Care Oxford Handbook of Psychiatry 3e Oxford Handbook of Public Health Practice 2e Oxford Handbook of Reproductive Medicine & Family Planning Oxford Handbook of Respiratory Medicine 2e Oxford Handbook of Rheumatology 3e Oxford Handbook of Sport and Exercise Medicine 2e Oxford Handbook of Tropical Medicine 3e Oxford Handbook of Urology 3e Oxford Handbook of Clinical Surgery Fourth edition Edited by Greg McLatchie Consultant Surgeon, Hartlepool General Hospital, Hartlepool, UK Neil Borley Consultant Colorectal Surgeon, Cheltenham General Hospital, Cheltenham, UK Joanna Chikwe Associate Professor, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, United States 1 3 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press, 2013 The moral rights of the authors have been asserted First Edition published 1990 Second Edition published 2002 Third Edition published 2007 Fourth Edition published 2013 Impression: 1 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer British Library Cataloguing in Publication Data Data available ISBN 978–0–19–969947–6 (fl exicover: alk.paper) Printed in China by C&C Offset Printing Co. Ltd. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers, and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text, or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. v Preface to the fourth edition Sometimes we have to look backward to look forward. Since 1990, sur- gery has witnessed cataclysmic changes. In our Trust, the fi rst laparoscopic cholecystectomy was performed in 1992, and has now become the pro- cedure of choice for most gall bladder disease and many other surgical operations in the western world. With the expansion of laparoscopic surgery, we have encountered a whole new range of complications with an escalation in the demise of general surgery as the result of hyperspe- cialization. There are many surgical trainees who have scant experience of open surgery and who have, due to European directives, limited time exposure to surgical procedures. In fact, most technical training is now obtained from emergency on call such that a new speciality of emergency surgery is developing. A recent British Medical Journal (BMJ) article recom- mended a training programme for surgeons wishing to work in remote and rural surgery—not only in the Developing World, but in remote and isolated communities in the United Kingdom! General surgery may largely have gone, but it should not be forgotten. Most countries in the world do not have access to these recent innovations and there is still a case in the developed world for experience in open and general surgery to be incor- porated in the formal training programmes of junior surgeons. G. R. McLatchie Hartlepool, September 2012 vi Preface to the third edition This, the third edition of the Oxford Handbook of Clinical Surgery, refl ects the changes which have occurred in general surgery over the 17 years since the fi rst edition was published. Firstly, we have recruited the services of two new editors, a stark con- trast to the original, which was written by a single author with the assis- tance of a surgical registrar. Secondly, each chapter has been written by a specialist consultant or registrar in the subject and, therefore, presents a modern, state-of-the-art treatise on each topic. Again, each condition is covered in the original two-page format with blank pages for accompanying notes. I am particularly grateful for the commitment that Jo Chikwe and Neil Borley have made, and also wish to thank staff at Oxford University Press for their support and patience. I am also grateful for the contribution and support given by many colleagues. G. R. McLatchie Hartlepool, March 2007 vii Preface to the fi rst edition The idea of this book was fi rst suggested by Mr Gordon McBain, consult- ant surgeon at the Southern General Hospital, Glasgow. We have received considerable support from the staff of Oxford University Press, and are also indebted to Mr J. Rhind and Dr J. Daniel for their contributions and our surgical teachers, especially Mr J. S. F. Hutchison, Mr M. K. Browne, Mr J. Neilson, Mr D. Young, Mr A. Young, and the late Mr I. McLennan whose practical advice and anecdotes pepper the pages…. G. R. McLatchie S. Parameswaran 1990 viii Dedications For Ross, Cameron, Ailidh, Claire, and Calum GRM For Alexander, Christopher, and Jennifer NB Acknowledgements We are grateful to the support of our colleagues and Oxford University Press and to Mrs Pamela Lines for her diligent support in the fi nal editing of the manuscript. ix Contents Detailed contents xi Contributors xxiii Symbols and abbreviations xxv 1 Good surgical practice 1 2 Principles of surgery 23 3 Surgical pathology 141 4 Practical procedures 185 5 Head and neck surgery 221 6 Breast and endocrine surgery 239 7 Upper gastrointestinal surgery 271 8 Liver, pancreatic, and biliary surgery 311 9 Abdominal wall 335 10 Urology 353 11 Colorectal surgery 391 12 Paediatric surgery 423 13 Paediatric orthopaedic 457 14 Major trauma 477 15 Orthopaedic surgery 489 16 Plastic surgery 589 17 Cardiothoracic surgery 619 18 Peripheral vascular disease 641 19 Transplantation 675 20 Surgery in tropical diseases 701 21 Common operations 729 22 Eponymous terms and rarities 757 Anatomy and physiology key revision points index 777 Index 779 This page intentionally left blank xi Detailed contents Contributors xxiii Symbols and abbreviations xxv 1 Good surgical practice 1 Duties of a doctor 2 Communication skills 4 Evidence-based surgery 6 Critical appraisal 10 Audit 12 Consent 14 Death 16 End-of-life issues 18 Clinical governance 20 2 Principles of surgery 23 Terminology in surgery 24 History taking and making notes 26 Common surgical symptoms 28 Examination and investigation of the patient: Evaluation of breast disease 30 Evaluation of the neck 32 Evaluation of the abdomen 34 Abdominal investigations 36 Evaluation of pelvic disease 38 Evaluation of peripheral vascular disease 40
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