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Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 1281 - файл
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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
Evaluation of the skin and subcutaneous tissue disease 42
Surgery at the extremes of age 44
Day case and minimally invasive surgery 46
Preoperative care:
Surgery in pregnancy 48
Surgery and the contraceptive pill 50
Surgery in endocrine disease 52
xi
DETAILED CONTENTS
xii
Surgery and heart disease 54
Surgery and respiratory disease 58
Surgery in renal and hepatic disease 60
Surgery in neurological disease 62
Pre-optimization of the patient:
Fluid optimization 64
Nutrition in surgical patients 66
Enhanced recovery after surgery 68
Perioperative care:
Getting the patient to theatre 70
Prophylaxis—antibiotics and thromboprophylaxis 72
In-theatre preparation 74
Positioning the patient 76
Sterilization, disinfection, and antisepsis 78
Scrubbing up 79
Surgical instruments 80
Incisions and closures 82
Drains 83
Stomas 84
Knots and sutures 86
Post-operative:
Post-operative management 88
Drain management 90
Fluid management 92
Acid–base balance 94
Blood products and procoagulants 96
Transfusion reactions 98
Shock 100
Post-operative haemorrhage 102
Wound emergencies 104
Cardiac complications 106
Respiratory complications 108
Renal complications 110
Urinary complications 112
Gastrointestinal complications 114
Neurological complications 116
Haematological complications 118
Deep venous thrombosis and pulmonary embolism 120
Risk scoring 122
DETAILED CONTENTS
Critical care 124
Commonly used terms in ITU 126
Invasive monitoring 128
Ventilation and respiratory support 130
Circulatory support 132
Renal support 134
Enteral support 136
Sepsis, SIRS, MODS, and ALI 138
3 Surgical pathology 141
Cellular injury 142
Infl ammation 144
Wound healing 146
Ulcers 148
Cysts, sinuses, and fi stulas 150
Atherosclerosis 152
Thromboembolic disease 154
Gangrene and capillary ischaemia 158
Tumours 160
Carcinogenesis 162
Screening 164
Grading and staging 168
Tumour markers 170
Surgical microbiology 172
Surgically important organisms 174
Soft tissue infections 176
Blood-borne viruses and surgery 178
Bleeding and coagulation 180
Anaemia and polycythaemia 182
xiii
4 Practical procedures 185
Endotracheal intubation 186
Cardioversion 188
Defi brillation 190
Venepuncture 192
Intravenous cannulation 194
Arterial puncture and lines 196
Insertion of central venous catheter 198
DETAILED CONTENTS
xiv
Chest drain insertion 200
Management of chest drains 202
Pericardiocentesis 204
Cricothyroidotomy 206
Nasogastric tube insertion 208
Urethral catheterization 210
Suprapubic catheterization 212
Paracentesis abdominis 214
Rigid sigmoidoscopy 216
Local anaesthesia 218
Intercostal nerve block 220
5 Head and neck surgery 221
Thyroglossal cyst, sinus, and fi stula 222
Branchial cyst, sinus, and fi stula 224
Salivary calculi 226
Acute parotitis 228
Salivary gland tumours 230
Head and neck cancer 232
Facial trauma 234
Neck space infections 236
6 Breast and endocrine surgery 239
Breast cancer 240
Surgical treatment of breast cancer 242
Breast cancer screening 244
Benign breast disease 246
Acute breast pain 248
Goitre 250
Thyrotoxicosis 252
Thyroid tumours—types and features 254
Thyroid tumours—diagnosis and treatment 256
Post-thyroid surgery emergencies 258
Primary hyperparathyroidism 260
Multiple endocrine neoplasia 262
Cushing’s syndrome 264
Conn’s syndrome 266
Phaeochromocytoma 268
DETAILED CONTENTS
7 Upper gastrointestinal surgery 271
Upper gastrointestinal endoscopy 272
Oesophageal motility disorders 274
Pharyngeal pouch 276
Hiatus hernia 278
Gastro-oesophageal refl ux disease 280
Oesophageal tumours 282
Peptic ulcer disease 284
Gastric tumours 286
Chronic intestinal ischaemia 288
Surgery for morbid obesity 290
Small bowel tumours 292
Acute haematemesis 294
Acute upper GI perforation 296
Acute appendicitis 298
Acute peritonitis 300
Acute abdominal pain 302
Gynaecological causes of lower abdominal pain 306
Intra-abdominal abscess 308
8 Liver, pancreatic, and biliary surgery 311
Jaundice—causes and diagnosis 312
Jaundice—management 314
Gall bladder stones 316
Common bile duct stones 318
Chronic pancreatitis 320
Portal hypertension 322
Cirrhosis of the liver 324
Pancreatic cancer 326
Cancer of the liver, gall bladder, and biliary tree 328
Acute variceal haemorrhage 330
Acute pancreatitis 332
xv
9 Abdominal wall 335
Abdominal wall hernias 336
Inguinal hernia 338
Femoral hernia 340
Umbilical and epigastric hernias 342
DETAILED CONTENTS
xvi
Incisional hernias 344
Other types of hernia 346
Rectus sheath haematoma 347
Groin disruption 348
Acute groin swelling 350
10 Urology 353
Symptoms and signs in urology 354
Investigations of urinary tract disease 356
Urinary tract stones 358
Obstruction of the ureter 360
Benign prostatic hyperplasia 362
Stricture of the urethra 364
Scrotal swellings 366
Disorders of the foreskin 368
Common conditions of the penis 370
Erectile dysfunction 372
Adenocarcinoma of the kidney 374
Transitional cell tumours 376
Adenocarcinoma of the prostate 378
Carcinoma of the penis 380
Testicular tumours 382
Haematuria 384
Acute urinary retention (AUR) 386
Acute testicular pain 388
11 Colorectal surgery 391
Ulcerative colitis 392
Crohn’s disease 394
Other forms of colitis 396
Colorectal polyps 398
Colorectal cancer 400
Restorative pelvic surgery 402
Minimally invasive colorectal surgery 403
Diverticular disease of the colon 404
Rectal prolapse 406
Pilonidal sinus disease 408
Fistula-in-ano 410
Haemorrhoids 412
DETAILED CONTENTS
Acute anorectal pain 414
Acute rectal bleeding 416
Acute severe colitis 418
Post-operative anastomotic leakage 420
12 Paediatric surgery 423
Principles of managing paediatric surgical cases 424
Acute abdominal emergencies—overview 426
Oesophageal atresia 428
Pyloric stenosis 430
Malrotation and volvulus 432
Intussusception 434
Hirschsprung’s disease 436
Rare causes of intestinal obstruction 438
Abdominal wall defects 440
Necrotizing enterocolitis (NEC) 442
Inguinal hernia and scrotal swellings 444
Other childhood hernias 446
Prepuce (foreskin) and circumcision 448
Undescended testis 450
Solid tumours of childhood 452
Neck swellings 454
13 Paediatric orthopaedic 457
Developmental dysplasia of the hip (DDH) 458
Slipped upper femoral epiphysis (SUFE) 460
The limping child 462
The child with a fracture 464
Non-accidental injury (NAI) 466
Legg–Calvé–Perthes disease 468
Motor development 470
Club foot or congenital talipes equinovarus (CTEV) 471
Flat feet (pes planus) 472
The osteochondritides 474
xvii
14 Major trauma 477
Management of major trauma 478
Thoracic injuries 480
DETAILED CONTENTS
xviii
Abdominal trauma 482
Vascular injuries 484
Head injuries 486
15 Orthopaedic surgery 489
Examination of a joint 490
Examination of the limbs and trunk 492
Fracture healing 494
Reduction and fi xation of fractures 498
The skeletal radiograph 502
Injuries of the phalanges and metacarpals 504
Wrist injuries 508
Fractures of the distal radius and ulna 510
Fractures of the radius and ulnar shaft 512
Fractures and dislocations around the elbow in children 514
Fractures of the humeral shaft and elbow in adults 518
Dislocations and fracture dislocations of the elbow 522
Fractures around the shoulder 524
Dislocations of the shoulder region 526
Fractures of the ribs and sternum 530
Fractures of the pelvis 532
Femoral neck fractures 536
Femoral shaft fractures 538
Fractures of the tibial shaft 540
Fractures of the ankle 544
Fractures of the tarsus and foot 546
Injuries and the spinal radiograph 550
Spinal injuries 554
Acute haematogenous osteomyelitis 558
Chronic osteomyelitis 560
Septic arthritis 562
Peripheral nerve injuries 564
Brachial plexus injuries 566
Osteoarthrosis (osteoarthritis) 568
Carpal tunnel syndrome 570
Ganglion 572
Bone tumours 574
Low back pain 578
Paget’s disease (osteitis deformans) 582
The great toe 584
DETAILED CONTENTS
Arthroplasty 586
Useful reading 588
16 Plastic surgery 589
Suturing wounds 590
Skin grafts 594
Surgical fl aps 596
Management of scars 598
Excision of simple cutaneous lesions 600
Skin cancer 602
Burns: assessment 604
Burns: management 606
Soft tissue hand injuries 610
Hand infections 612
Dupuytren’s disease 614
Breast reduction 616
Breast augmentation 617
Breast reconstruction 618
17 Cardiothoracic surgery 619
Basics 620
Principles of cardiac surgery 622
Coronary artery disease 626
Valvular heart disease 628
Cardiothoracic ICU 630
Lung cancer 632
Pleural effusion 634
Pneumothorax 636
Mediastinal disease 638
xix
18 Peripheral vascular disease 641
Acute limb ischaemia 642
Chronic upper limb ischaemia 644
Chronic lower limb ischaemia 647
Intermittent claudication 648
Critical limb ischaemia 650
Aneurysms 652
Ruptured abdominal aortic aneurysm 654
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