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The global population is aging rapidly, and as a result emergency abdominal surgery for acute abdomen in the elderly has become a global issue. Demographic changes in the population have also altered the profile of emergency abdominal surgery, with typical causes of acute abdomen in the elderly including acute cholecystitis, incarcerated hernia, bowel obstruction and appendicitis. In these patients, recovery from surgery is often complicated, leading to longer hospital stays compared with younger patients. Laparoscopy in the emergency setting is well established and offers a number of advantages over open surgical approaches, such as reduced postoperative pain, length of hospital stay and complication rates. While laparoscopic surgery for acute diverticulitis has become more widespread, in other conditions, like small bowel obstruction and perforated peptic ulcer, laparotomy is still used in about 70% of cases. Further, despite the urgent need for knowledge regarding surgical treatment of acute abdomen in the elderly, there is still a lack of evidence in this relevant clinical field. This book analyzes the management strategies and critically evaluates the outcomes of laparoscopic emergency surgery for acute abdomen in the elderly according to the principles of evidence-based medicine. Discussing each topic clearly, and promoting the use of emergency laparoscopy in elderly patients, the book is intended for young general surgeons and surgeons in training with at least a basic knowledge of surgery for acute abdomen. It is also useful as a quick reference tool during on-call shifts.
This book provides up-to-date evidence on laparoscopic emergency surgery and supplies concrete advice on when and how to approach patients laparoscopically in an emergency setting. All the diseases elegible for emergency laparoscopy are addressed, and for each disease recommendations, levels of evidence, and technical key points are discussed and analyzed. Diagnostic flow charts are included for cases in which laparoscopy turns out to be the final diagnostic step and the first therapeutic one. Furthermore, problematic and positive aspects of the laparoscopic approach from the anesthesiologic point of view are fully explored. Finally, a useful overview of current practice in hospitals across the world is provided, highlighting the varying applications in relation to different medical “cultures”, skills, resources, and healthcare systems.
The field of emergency general surgery encompasses a wide array of surgical diseases, ranging from the simple to the complex. These diseases may include inflammatory, infectious, and hemorrhagic processes spanning the entire gastrointestinal tract. Complications of abdominal wall hernias, compartment syndromes, skin and soft tissue infections, and surgical diseases are significantly complex in special populations, including elderly, obese, pregnant, immunocompromised, and cirrhotic patients. This book covers emergency general surgery topics in a succinct, practical and understandable fashion. After reviewing the general principles in caring for the emergency general surgery patient, this text discusses current evidence and the best practices stratified by organ system, including esophageal, gastroduodenal, hepatobiliary and pancreatic, small and large bowel, anorectal, thoracic, and hernias. Chapters are written by experts in the field and present a logical, straightforward, and easy to understand approach to the emergency general surgery patient, as well as provide patient care algorithms where appropriate. Emergency General Surgery: A Practical Approach provides surgeons and surgery residents with a practical and evidence-based approach to diagnosing and managing a wide array of surgical diseases encountered on emergency general surgery call.
There is a growing need for a book on emergency general surgery in the elderly, as adults age 65 and older are the fastest growing segment of the population worldwide, and their number is expected to double to 89 million between now and 2050. Based on these changing demographics, it is expected that there will be a concurrent rise in the demand for a variety of surgical services, including vascular surgery (with a projected growth of 31%) and general surgery (with a projected growth of 18%), as well as in all sub-disciplines of surgery (thoracic, cardiac, oncology, hepatobiliary, transplant, plastic colorectal, orthopedic, gynecologic, urology and neurosurgery).In addition, older surgical patients often require a different level of care than younger patients during the preoperative, intraoperative and postoperative phases. Many of our geriatric population have multiple chronic illnesses beyond the one for which surgery is required, and therefore are prone to developing postoperative complications, functional decline, loss of independence, and other undesirable outcomes. In response, this book offers surgeons, geriatrists and nurses state-of-the-art surgical approaches and essential information on the complex perioperative care of the elderly.
This book is the first available practical manual on the open abdomen. Practicing physicians, surgeons, anesthesiologists, nurses, and physiotherapists will find in it a ready source of information on all aspects of open abdomen management in a wide variety of settings. The coverage includes, for example, the open abdomen in trauma, intra-abdominal sepsis, and acute pancreatitis, step-by-step descriptions of different techniques with the aid of high-quality color figures, guidance on potential complications and their management, and features of management in different age groups. The book contents illustrate the most recent innovations and drawing upon a thorough and up-to-date literature review. Useful tips and tricks are highlighted, and the book is designed to support in daily decision making. The authors include worldwide opinion leaders in the field, guaranteeing the high scientific value of the content.
This comprehensive volume provides a practical framework for evaluation, management and disposition of this growing vulnerable patient population.
This is the first time a book about laparoscopy in emergency abdominal surgery has been published. Numerous articles have been published in specific surgical journals, but, until now, there has not been a book that collates all the aspects of this little-known field. The aim of this volume is to achieve a complete and easy presentation of all the implications associated with laparoscopy in emergency abdominal surgery. The book should be a manual that can be easily consulted by digestive, general, and specialized surgeons, especially in an emergency. The authors’ contributions are founded on evidence-based medicine, which give the book scientific credibility, but this is coupled with their experience of daily practice, which adds an important complementary dimension to evidence-based medicine. This is balanced by an emphasis on clarity and accessibility, because the ultimate aim of the book is educational. We hope this book will be frequently consulted, in depth, not only by specialist practitioners, but also by undergraduate students, new graduates and surgeons in training.
"In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be "geriatric surgeons," but to assemble a comprehensive account that will allow "all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients." This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field." NEJM Book Review
Emergency Surgery provides both a practical guide and an understanding of the issues that need to be considered in the management of emergency surgery patients. It presents a clear account of the key issues involved in the assessment, investigation, resuscitation and surgical management of patients who present to the on-call emergency team. It considers the full breadth of issues encountered in these patients including anaesthesia, pre-op resuscitation/optimization, and initial post-operative care including preliminary high dependency/critical care, as well as the complications and acute issues found in acute surgical patients on the ward. It is ideal for surgical trainees as well as trainees from other specialties involved in the care of these complex and challenging patients. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store.
A practical guide to perioperative cognitive disorders, the most common complications of anesthesia and surgery in older people.