Добавил:
kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:

Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 864 - файл

.pdf
Скачиваний:
0
Добавлен:
29.08.2026
Размер:
10 Мб
Скачать
Primary Management in General, Vascular and Thoracic Surgery
APractical Approach
DanieleBissacco AlbertoM.Settembrini AndreaMazzari
123
Primary Management in General, Vascular and Thoracic Surgery
Daniele Bissacco • Alberto M. Settembrini Andrea Mazzari
Editors
Primary Management in General, Vascular and Thoracic Surgery
APractical Approach
Editors
Daniele Bissacco Vascular Surgery Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Italy
Andrea Mazzari Mini-invasive and General Surgery Unit Ospedale Cristo Re Rome, Italy
Alberto M. Settembrini Vascular Surgery Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Italy
ISBN 978-3-031-12562-1 ISBN 978-3-031-12563-8 (eBook)
https://doi.org/10.1007/978-3-031-12563-8
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
https://t.me/medicina_free
A specialist doctor is a man who knows more and more about less and less.
Dr. William J.Mayo
Fudit equum magno tellus percussa tridenti.
Virgilio, Georgiche 1 1-42 These are two phrases that strike us to the heart.
Mayo is the founder of one of the most important hospitals in the world, and his phrase is a motto for all doctors who have married their work following the deep meaning of the word “doctor” by taking care of all patients.
Virgil’s phrase must be translated into medical words considering that the teacher must prepare young surgeons to learn and make their own the lessons received from the experience of the elders.
Medicine is a eld where changes are inevitable, but changes are not always evolutions. To be good doctors, it is imperative to know the biology and processes of the body’s biological behavior and, from there, try to identify changes and evolu­tions in therapies and treatments.
Indeed, in surgery it is essential to know the difference between the basics and the evolution of techniques.
The basics of surgery are the cornerstones of surgical growth for surgeons, but all good doctors and surgeons must keep in mind that the rst approach to the patient is the correct diagnosis and management.
Why? The question can be answered by tracing its historical development over the centuries to identify the fundamental steps that depend closely on the evolution of thought. Why? The basis of surgery is not the hands but the head.
The decision-making process is the rst and sometimes the most important con­dition to be addressed before treatment.
Our book is intended to be a concise but comprehensive guide for quick consul­tation by our younger colleagues on various clinical situations.
This book is for young surgeons by young surgeons. SPIGC (Italian Polyspecialistic Society of Young Surgeons) has endorsed this publication because who can be a better advisor to a young surgeon than another young surgeon who is more experienced, more skilled, and knowledgeable in a specic eld.
Practical advice is given for all stages of management, and all chapters are rich in references and illustrations to provide additional reading to those who want more in-depth coverage.
v
vi
https://t.me/medicina_free
Preface
This is the reason why the authors have written very practical and up-to-date chapters on different but frequent pathologies of the most critical surgical elds: general, thoracic, and vascular surgery.
Milan, Italy DanieleBissacco Milan, Italy AlbertoM.Settembrini Rome, Italy AndreaMazzari
Contents
https://t.me/medicina_free
1 Historical Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
E. Botteri, F. Bongiovanni, R. L. Meniconi, and E. Grespi
Part I Surgical Instruments and Materials
2 Surgical Instruments and Materials in General Surgery . . . . . . . . . . . 7
Andrea Mazzari, Pasquina M. C. Tomaiuolo, and Roberto Luca Meniconi
3 Surgical Instruments and Materials in Thoracic Surgery . . . . . . . . . . 15
Valeria Musso and Francesco Damarco
4 Surgical Instruments and Materials in Vascular Surgery . . . . . . . . . . . 21
Ilenia D’Alessio and Matteo Marone
Part II Neck
5 Supra-aortic Trunks Emergency Conditions . . . . . . . . . . . . . . . . . . . . . 33
Enza Lucia Castronovo, Daniele Bissacco, D’Oria Mario, Alberto M. Settembrini, and Sirignano Pasqualino
6 Upper Airways Tract in Emergency Settings . . . . . . . . . . . . . . . . . . . . . 49
Diotti Cristina and Francesco Damarco
7 Multidisciplinary Surgical Consensus on Neck Emergencies . . . . . . . . 63
Emanuela Fuccillo and Marco Giovenzana
Part III Chest
8 Chest: Surgical Anatomy and General Consideration
in Emergency Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Valeria Musso and Francesco Damarco
9 Acute Aortic Syndromes and Thoracic Aortic Aneurysms:
From Diagnosis to Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Andrea Xodo, Andrea Gallo, Paolo Magagna, and Mario D’Oria
vii
viii
https://t.me/medicina_free
Contents
10 Pulmonary and Thoracic Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Francesco Damarco
11 Upper Gastrointestinal Tract Acute Conditions . . . . . . . . . . . . . . . . . . . 119
Marco Giovenzana, Beatrice Giuliani, and Nicolò Maria Mariani
12 Multidisciplinary Surgical Consensus on Chest Emergencies . . . . . . . 129
Francesco Damarco, Marco Giovenzana, Diotti Cristina, and Valeria Musso
Part IV Abdomen
13 Abdomen: Surgical Anatomy and General Consideration
in Emergency Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Sarah Molno, Giampaolo Bertoloni, and Gian Luca Baiocchi
14 Acute Abdominal Aorta and Visceral Vessel Disease . . . . . . . . . . . . . . . 145
Davide Esposito and Elena Giacomelli
15 Acute Abdomen and Acute Abdominal Conditions . . . . . . . . . . . . . . . . 153
Emanuele Botteri, Gianmaria Casoni Pattacini, Alessio Giordano, and Francesca Ratti
16 Abdominal Emergencies Requiring a Multidisciplinary Approach . . . 175
Andrea Mazzari, Pasquina M. C. Tomaiuolo, Alessio Giordano, Roberto Luca Meniconi, and Alberto M. Settembrini
Part V Upper and Lower Limbs
17 Upper and Lower Limbs: Surgical Anatomy and General
Consideration in Emergency Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Matteo Marone and Ilenia D’Alessio
18 Acute and Chronic Limb Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Giuseppe Galzerano, Edoardo Pasqui, Gianluca Chierchini, Alberto M. Settembrini, and Pasqualino Sirignano
19 Popliteal Artery Aneurysm and Non- atherosclerotic Limb Disease . . . 207
Alberto M. Settembrini and Pasqualino Sirignano
Part VI Specic Clinical Pictures: Surgeon Perspectives
20 The Infected and Septic Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Emanuele Botteri, Nicoletta Lazzeri, Silvia Mazzoleni, and Frank A. Rasulo
21 Hemorrhagic Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Samuele Colombo and Daniele Bissacco
22 The Polytrauma Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Matteo Marone and Ilenia D’Alessio
Historical Overview
https://t.me/medicina_free
E.Botteri, F.Bongiovanni, R.L.Meniconi, andE.Grespi
1.1 New Science
Understanding the origins of ‘new’ scientic knowledge, understanding what and who took the rst steps towards breaking free from superstition, supernatural, rigid and immutable beliefs, is a considerable cultural step and one which brings full enjoyment of what science can offer us both as individuals and as members of the scientic community. Above all, intellectual effort calls for a critical mind, in order not to simply accept what is transmitted to us. Thinking can and should be remodelled by everyone, according to well-accepted methods to make it ever more detailed and in keeping with the reality we wish to convey. It requires intel­lectual honesty, as well as specialised training, and once conclusions have been reached about any piece of work, the results should be conveyed to everyone involved. While ‘our’ centuries-old science has managed to overcome supersti­tion, an anti-scientic attitude has remained on the side-lines of human thought, threatening its very foundations whenever an immediate explanation to a phenom­enon cannot be provided. Science takes time and requires patience, a sound mind and method.
Let us not forget that many of the western world’s values and perceptions are inspired by the scientic method and the resulting technical progress. The ‘Scientic
1
E. Botteri (*) General Surgery Unit, ASST Spedali Civili di Brescia, Brescia, Italy
F. Bongiovanni · E. Grespi Department of Anesthesiology and Intensive Care Medicine II, Spedali Civili, University of Brescia, Brescia, Italy
R. L. Meniconi Department of General Surgery and Organ Transplantation, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 D. Bissacco et al. (eds.), Primary Management in General, Vascular and Thoracic Surgery, https://doi.org/10.1007/978-3-031-12563-8_1
1
2
https://t.me/medicina_free
Method’, its concepts and its dissemination underpinned the veritable knowledge revolution of the seventeenth century. The Scientic Method represents ‘the rules of the game’ and covers three elements in its scope:
1. LOGIC and its inductive methods (the effects are observed to conrm the causes,
according to a process of subsequent reasoning) and deductive methods (from the cause, the effects are hypothesised, according to a process of prior reasoning).
2. Systematic application of OBSERVATION, not for mere description purposes,
but rather in order to inspire EXPERIMENTATION.Every hypothesis must go hand in hand with repetition and reproducible tests in order for it to be afrmed.
3. Speaking the same language: the language of MATHEMATICS.Galileo Galilei
claimed that ‘the universe is written in the language of mathematics’. Used in Plato’s era as the language of nature, especially in geometry, to avoid being mis­led by pure sensory experiences.
The main advocates of this development were three scientists closely linked to one another by the knowledge that ‘we have been too inefcient thus far’, Galileo Galilei, Renè Descartes and Francis Bacon.
Nevertheless, New Science gured little, at least to begin with, in the world in which it emerged. Inevitably, new institutions were needed; composed of people involved with specic scientic elds, supported by patrons or corporations with the aim of facilitating communication and debate in the scientic community—the SCIENTIFIC SOCIETIES were born.
1606 saw the launch of Rome’s Lincean Academy, quickly followed by the Accademia del Cimento (1657), Paris’ Academy of Sciences (1666) and the Royal Society (1660). In the latter, the inuence of the new cultural climate was so strong that the ne arts, rhetoric, metaphysics and theology were excluded from the Articles of Association (without, however, undermining their prominence). The importance of communicating ideas was supported by their own dissemination means and jour­nals such as the Philosophical Transaction, Acta Eruditorum and the Journal de Savants.
At all levels, scientic research products should therefore be made accessible, employing the correct language for the target audience.
E. Botteri et al.
1.2 Young People inScience
When we speak about young people in science, particularly about the contribution, young people have made, make and will make, is not only a matter of age. Being young implies a new mental approach and boundless physical endurance. One could wonder who was the rst ‘young surgeon’ to have both a young mind and a youthful age. There is no doubt as to the answer: Giovanni Battista Morgagni (Forlì 1682­Padua 1771). He studied under Valsalva in Bologna before moving to the Republic of Venice and nally settling down in Padua in 1711, when he was called to the second chair of theoretical medicine.
Соседние файлы в папке @xirurgi_2025