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The proposal for this book is to offer a systematic description of the most frequent complications occurring in the three parts of the digestive tract: HPB, Upper GI and colorectal tracts. Every complication, from esophageal to the rectum, is described systematically through two or three practical cases as has been treated by actual surgical practices of authors serving as surgeon practitioners. Description of the case, presentation of indication for surgery, type of primary surgical intervention and complication is described textually but also and by means of clinical signs, laboratory tests, radiological studies (CT scans and schematic drawings) and other methods used for diagnosis and treatment. The reader will have access to a practical book in which every current complication can be easily recognized, along with relevant information as guide for an adequate treatment.
A general handbook covering post-surgical complications across all specialties. Particularly relevant for junior doctors and those preparing for their membership of the Royal College of Surgery (MRCS) exams.
Any surgical intervention, elective or acute, may lead to postoperative complications. Moreover, the pertaining approach - laparoscopic or open - will probably not differ in the morbidity rate after surgery. Complications that occur after a surgical intervention can be classified as major or minor. Major complications to the digestive tract after surgery imply in most of cases a leakage of an anastomosis, bleeding in the abdominal cavity or in the tract, the appearance of intraperitoneal abscesses, or surgical site infections and wound dehiscence. These complications, depending on the organ affected, upper GI, HPB tract or colorectal, are associated with high morbidity and mortality. Early suspicion and diagnosis, followed by an early and effective treatment is imperative in order to reduce the morbidity and mortality. Adequate treatment will involve a good coordination of the three disciplines involved in treatment: the surgeon, the intervention radiologist, and the gastroenterologist. Approach of these postoperative complications is changing constantly and these changes are not properly known by general and more specialized digestive surgeons daily involved in the treatment of these diseases. The proposal for this book is to offer a systematic description of the most frequent complications occurring in the three above mentioned parts of the digestive tract. In this way, the reader will have access to a practical book in which every current complication can be easily recognized, along with relevant information as guide for an adequate treatment.
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.
Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
The authors review the results of various laparoscopic colorectal procedures and identify the range of complications associated with this surgery. Providing a unique global perspective on colorectal results, the book is divided into four sections: basic principles, pathology and procedure, adjuncts to laparoscopy, and world views on the surgery. Discussions of management during surgery are also included.
Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.
Primum non nocere... The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic... It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela? This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book.
Adhesions can cause a wide range of problems, complaints and hazards, even after simple abdominal procedures, such as appendectomy, with complications ranging from recurrent discomfort and pain to intestinal obstruction. Postsurgical adhesions increase the risk of following operations of the abdominal and thoracic cavity. They impair peritoneal dialysis and chemotherapy and play a crucial part in laparoscopic procedures. Adhesion-related problems account for a large amount of clinical work and have a significant socioeconomic impact. This book presents the current knowledge on the aetiopathogenesis of adhesion formation as well as the available methods for their prevention and control. Experts in the field contribute to clinical standards for preventive measures to control the formation of postoperative adhesions