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27 Stanley J Dudrick: A Life of a Giant in Surgery and Surgical Decision to Transition to a New Role or No…
333
3. Dudrick SJ, Drick S.Longterm total parenteral nutrition with growth in puppies and positive nitrogen balance in patient. Surg Forum. 1967;18:356–7.
4. Dudrick SJ. Rhoads Lecture: a 45-year obsession
and passionate pursuit of optimal nutrition support:
puppies, pediatrics, surgery, geriatrics, home TPN,
A.S.P.E.N., et cetera. JPEN J Parenter Enteral Nutr.
2005;29(4):272–87. https://doi.org/10.1177/0148607
105029004272.
5. Dudrick SJ.History of parenteral nutrition. J Am Coll
Nutr. 2009;28(3):243–51. https://doi.org/10.1080/073
15724.2009.10719778.
6. Dudrick SJ, Lati R.Total parenteral nutrition in surgery current status. Contemp Surg. 1992;41:41–8.
7. Dudrick SJ, Lati R, Adams PR.Arrest and reversal
of atherosclerosis with parenteral nutrition. Surg Clin
NA. 1991;71(3):665–75. PMID 1904650.
8. Dudrick SJ, Lati R, Fosnocht D. Management
of the short bowel syndrome. Surg Clin NA.
1991;71(3):625–43.
9. Dudrick SJ, Lati R, Schrager R.Nutritional management of inammatory bowel disease. Surg Clin NA.
1991;71(3):609–23.
10. Lati R, McIntosh J, Dudrick SJ. Nutritional support in acute and chronic pancreatitis. Surg Clin NA.
1991;71(3):579–95. PMID 1904645.
11. Lati R, Killam R, Dudrick SJ. Nutritional support
in liver failure. Surg Clin NA. 1991;71(3):567–478.
12. Gould KL, Martucci JP, Goldberg DI, Hess MJ,
Lati R, Dudrick SJ.Short term cholesterol lowering
decreases size and severity of perfusion abnormalities
by positron emission tomography after dipyridamole
in patients with coronary artery disease: a potential
noninvasive marker of healing coronary endothelium.
Circulation. 1994;89(4):1530–8. PMID 8149518.
13. Dudrick SJ, Lati R.Total parenteral nutrition part II:
administration, monitoring and complications. Pract
Gastroenterol. 1992;16(7):29–38.
14. Dudrick SJ, Lati R. Total parenteral nutrition part
I: indications and techniques. Pract Gastroenterol.
1992;16(6):21–9.
15. Lati R, Dudrick SJ, editors. The biology and practice of current nutrition support. 2nd ed. Landes
Bioscience: Georgetown; 2003.
16. DeMaria EJ, Lati R, Sugerman HJ, editors.
Laparoscopic bariatric surgery: techniques and outcomes. Landes Bioscience: Georgetown; 2002.
17. Lati R, Dudrick SJ, editors. Current surgical nutrition. Georgetown: R.G.Landes; 1996.
18. Dudrick SJ, Pimiento JM, Lati R. Short bowel
syndrome: a clinical update. In: Lati R, editor.
Surgery of complex abdominal wall defects: practical approaches. Cham: Springer International; 2017.
p.225–42.
19. Lati R, Dudrick S, Merrell R. The new surgeon:
patient-centered, disease-focused, technology-driven,
and team-oriented. In: Technological advances in surgery, trauma, and critical care. NewYork: Springer;
2015.
20. Dudrick S, Pimiento J, Lati R. Short bowel syndrome: a clinical update. In: Lati R, editor. Surgery
of complex abdominal wall defects. Springer Science+
Business Media NewYork; 2013.
21. Lati R, Dudrick SJ, Perch PG.Nutritional management of chronic pancreatitis: current concepts. In:
Lati R, Dudrick SJ, editors. The biology and practice
of current nutritional support. 2nd ed. Georgetown:
Landes Bioscience; 2003. p.334–45.
22. Lati R, SJ, Dudrick SJ. Nutrition support in acute
pancreatitis. In: Lati R, Dudrick SJ, editors. The
biology and practice of current nutritional support.
2nd ed. Georgetown: Landes Bioscience; 2003.
p.320–33.
23. Dudrick SJ, Fizan A, Lati R.Nutritional and metabolic management of short bowel syndrome. In: Lati
R, Dudrick SJ, editors. The biology and practice of
current nutritional support. 2nd ed. Georgetown:
Landes Bioscience; 2003. p.261–74.
24. Lati R, Dudrick SJ.Total parenteral nutrition: current concepts and practice. In: Lati R, Dudrick SJ,
editors. The biology and practice of current nutritional
support. 2nd ed. Georgetown: Landes Bioscience;
2003. p.208–18.
25. Horowitz D, Lati R.Radiologic assessment of nutritional and metabolic status. In: Lati R, Dudrick SJ,
editors. The biology and practice of current nutritional
support. 2nd ed. Georgetown: Landes Bioscience;
2003. p.181–91.
26. Lanning DA, Lati R. Wound healing: the role of
nutrient substrates. In: Lati R, Dudrick SJ, editors.
The biology and practice of current nutritional support. 2nd ed. Georgetown: Landes Bioscience; 2003.
p.88–102.
27. Azimuddin K, Lati R, Ivatury RR.Acute phase proteins: the utility in nutrition support of critically ill
patients. In: Lati R, Dudrick SJ, editors. The biology and practice of current nutritional support. 2nd
ed. Georgetown: Landes Bioscience; 2003. p.63–71.
28. Lati R, Azimuddin K.Biochemistry of amino acids:
clinical implications. In: Lati R, Dudrick SJ, editors.
The biology and practice of current nutritional support. 2nd ed. Georgetown: Landes Bioscience; 2003.
p.52–62.
29. Dudrick SJ, Lati R, Castro GA. Digestion and
absorption. In: O’Leary JP, editor. The physiologic
basis of surgery. 2nd ed. Baltimore: Williams &
Wilkins; 1996. p.365–75.
30. Mason GR, Kahrilas PJ, Otterson MF, Lang IM,
Telford GL, Telford SW, Sarna KS, Cowles VE, Koch
TR, Debas HT, Gittes G, Jaffe M, Dudrick SJ, Lati
R, Castro GA. The digestive system. In: O’Leary
JP, editor. The physiologic basis of surgery. 2nd ed.
Baltimore: Williams & Wilkins; 1996. p.406–40.
31. Dudrick SJ, Zarif A, Lati R.Nutritional and metabolic Management of Short Bowel Syndrome.
In: Lati R, Dudrick SJ, editors. Current surgical
nutrition. R.G.Landes and Chapman & Hall; 1996.
p.309–17.
334
R. Lati
32. Anain PM, Matarese LE, Lati R, Steiger E. Home
parenteral nutrition in patients with gastrointestinal
tract failure. In: Lati R, Dudrick SJ, editors. Current
surgical nutrition. R.G.Landes and Chapman & Hall;
1996. p.297–308.
33. Lati R, Burns GA, Dudrick SJ. Nutritional support of chronic pancreatitis. In: Lati R, Dudrick SJ,
editors. Current surgical nutrition. R.G. Landes and
Chapman & Hall; 1996. p.243–54.
34. Lati R, Dudrick SJ.Nutrition support of acute pancreatitis. In: Lati R, Dudrick SJ, editors. Current
surgical nutrition. R.G.Landes and Chapman & Hall;
1996. p.229–42.
35. Lati R, Dudrick SJ.Total parenteral nutrition: current concepts and indications. In: Lati R, Dudrick SJ,
editors. Current surgical nutrition. R.G. Landes and
Chapman & Hall; 1996. p.45–56.
36. Horowitz DR, Lati R. Radiological assessment of
nutritional and metabolic status. In: Lati R, Dudrick
SJ, editors. Current surgical nutrition. R.G. Landes
and Chapman & Hall; 1996. p.33–43.
37. Lati R, Dudrick SJ.Effects of nutrients in acute pancreatitis. In: Lati R, Dudrick SJ, editors. Surgical
nutrition: strategies in critically ill patients. SpringerVerlag, R.G.Landes; 1995. p.147–51.
38. Dudrick SJ, Lati R. Amino acids in critically ill
patients. In: Lati R, Dudrick SJ, editors. Surgical
nutrition: strategies in critically ill patients. SpringerVerlag, R.G.Landes; 1995. p.31–43.
39. Dudrick SJ, Lati R. Management of Patients with
short bowel syndrome. In: Kirby DF, Dudrick SJ,
editors. Practical handbook in clinical practice. CRC
Press; 1994. p.215–26.
40. Dudrick SJ, Lati R. Total parenteral nutrition. In:
Kirby DF, Dudrick SJ, editors. Practical handbook in
clinical practice. CRC Press; 1994. p.135–64.
41. Lati R, Dudrick SJ.Nutrition in surgical patients. In:
Kirby DF, Dudrick SJ, editors. Practical handbook in
clinical practice. CRC Press; 1994. p.165–82.
42. Lati R, Dudrick SJ.Hepatic encephalopathy: nutrition and metabolic implications of amino acids. In:
Lati R, editor. Amino acids in critical care and cancer. Austin: R.G.Landes Publishing Company; 1994.
p.125–36.
43. Dudrick SJ, Lati R. Nutritional support: general
principles, indications, and techniques. In: Quigley
EMM, Sorrell MF, editors. The gastrointestinal surgical patient: preoperative and postoperative care.
Baltimore: William & Wilkins; 1994.
44. Dudrick SJ, Lati R. Surgery and nutrition in the
elderly. In: O’Donnell P, editor. Geriatric urology. St.
Louis: Mosby; 1993. p.105–13.
45. Dudrick SJ, Lati R, Castro GA. Digestion and
absorption. In: O’Leary JP, editor. The physiologic
basis of surgery. Baltimore: Williams & Wilkins;
1993. p.365–75.
46. Mason GR, Kahrilas PJ, Otterson MF, Lang IM,
Telford GL, Telford SW, Sarna KS, Cowles VE, Koch
TR, Debas HT, Gittes G, Jaffe M, Dudrick SJ, Lati
R, Castro GA.The digestive system. In: O’Leary JP,
editor. The physiologic basis of surgery. Baltimore:
Williams & Wilkins; 1993. p.340–75.
47. Dudrick SJ, Lati R.Total parenteral nutrition in the
treatment of atherosclerosis. In: Van Way III CW, editor. Handbook of surgical nutrition. Philadelphia: JB
Lippincott; 1992. p.259–71.
48. Dudrick SJ, Adams PR, Englert DM, Lati R, Feste
A.Arrest and regression of atherosclerosis by intravenous infusion of specially formulated nutrient substrates. In: Takehiko T, Akira O, editors. Nutritional
support in organ failure. Amsterdam/New York/
Oxford: Elsevier; 1990.
Further Readings
Bhatt NR, Morris M, O’Neil A, Gillis A, Ridgway
PF. When should surgeons retire? Br J Surg.
2016;103(1):35–42. https://doi.org/10.1002/bjs.9925.
Epub 2015 Nov 18.
Gotlib Conn L, Wright FC.Retirement plans and perspec-
tives among general surgeons: a qualitative assessment. Can J Surg. 2018;61(5):319–25. https://doi.
org/10.1503/cjs.011217. PMID: 30246991; PMCID:
PMC6153102.
Anteby R, Sinyard RD 3rd, Healy MG, Warshaw AL,
Hodin R, Ellison EC, Phitayakorn R.Passing the scalpel: lessons on retirement planning from retired academic surgeons. Am J Surg. 2022;224(1 Pt A):166–71.
https://doi.org/10.1016/j.amjsurg.2021.11.025. Epub
2021 Nov 29.
Flint L, Scott-Conner CE. What constitutes a success-
ful retirement? Invited commentary on: Anteby and
coauthors, passing the scalpel: lessons on retirement
planning from retired academic surgeons. Am J Surg.
2022;224(1 Pt A):172–3. https://doi.org/10.1016/j.
amjsurg.2022.01.001. Epub 2022 Jan 6.
Buckley R. How do trauma surgeons retire with grace?
Injury. 2023;54(10):110999. https://doi.org/10.1016/j.
injury.2023.110999. Epub 2023 Aug 9.
Buccimazza I.When should surgeons retire? S Afr J Surg.
2016;54(4):3–4.
Hewitt L, Ashford B. Career reections of retired sur-
geons. ANZ J Surg. 2023;93(1–2):21–3. https://doi.
org/10.1111/ans.18173. Epub 2022 Nov 24.
Stolarski A, Moseley JM, O’Neal P, Whang E, Kristo
G. Retired surgeons’ reections on their careers.
JAMA Surg. 2020;155(4):359–61. https://doi.
org/10.1001/jamasurg.2019.5476. PMID: 31968054;
PMCID: PMC6990937.
Kim NE, Moseley JM, O’Neal P, Whang E, Itani KMF,
Kristo G. Retired surgeons as mentors for surgical
training graduates entering practice: an underutilized
resource. Ann Surg. 2021;273(3):613–7. https://doi.
org/10.1097/SLA.0000000000003272.
Part V
The Final Word
Epilogue: Quo Vadis Surgical
28
Decision-Making
RifatLati
“In a surgeon (Foreword to: Marx Thorek. Surgical Errors and Safeguards, Fourth
edition, Philadelphia: J.B.Lippincott Company; 1943.), there is no quality of mind more
to be desired than that of judgment. It is judgment even more than skill that makes him
truly a successful surgeon.”
Hugh Devine, 19431.
Introduction
In this epilogue as the concluding chapter of this
book on Surgical Decision-Making: Evidence
and Beyond, Second Edition, I want to remind
the reader one more time, the profound impact
that these decisions have on the lives of our
patients, and frankly in our own lives as surgeons
as well. Each page of every chapter of this book,
each case presented and analyzed, and each
insight shared by the authors have deepened our
understanding and brought us closer to the
nuances and dynamic nature of surgical
decision-making.
As we reect on the myriad factors that inuence surgical decision-making, it becomes clear
that it is not merely a matter of following guide-
R. Lati (*)
Department of Surgery, The University of Arizona,
Tucson, AZ, USA
Tucson Medical Center, Department of Surgery,
Tucson, AZ, USA
e-mail: Lati@surgery.arizona.edu
lines or protocols, or check list. It is a delicate
dance between art and science, a harmonious
blend of technical prociency and human compassion. Moreover, it is a culmination of experience, intuition, education, and unwavering
dedication to patient care that forms the foundation upon which these critical decisions are made.
These decisions, however, in case of emergencies
and when things are seemingly out of control, are
not always understandable by the team, and only
the surgeon may be able to explain the decision,
although not all the time.
Through the exploration of real-life scenarios
and review of the evidence in each chapter of this
book, and often real-life practices described by
authors, I am hoping that collectively as a group
of surgeons, interested in surgical decisionmaking, we have advanced the understanding of
this complex process and further uncovered the
inherent complexities and challenges that surgeons face in the decision-making process. In
doing so, this book reviews the role of and the
evolution of surgical practices, through advancements in technology, and the shifting paradigms
that shape our approach to patient care.
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2024
R. Lati (ed.), Surgical Decision-Making, https://doi.org/10.1007/978-3-031-67391-7_28
337
338
R. Lati
But let me warn you the reader: if you were
expecting to completely grasp how surgicalmaking decision by the conclusion of this book,
you may nd that you are not completely satised [1]. Although we have delved into various
aspects of this intricate topic, there are still many
unknowns that necessitate further research. This
research should be conducted by surgeons working together with experts who specialize in
understanding the mind, brain function, and
methods for inuencing or training the brain.
In his book “Modern Surgery” published as a
second edition in late 1939, Professor Max
Thorek, the founder of International College of
Surgeons, quotes the renowned English surgeon
Lord Moynihan in the rst chapter titled “The
Surgeon and his Art.”
Surgery is not only a matter of operating skill-
fully. It must engage in its service qualities of mind
and heart that raise it to the very highest pinnacle
of human endeavor. A patient can offer you no
higher tribute than to entrust you with his life and
his health, and by implication, with the happiness
of all his family. To be worthy of this trust we must
submit for a lifetime to the constant discipline of
unwearied effort in the search of knowledge, and
most reverent devotion to every detail in every
operation that we perform [2–4].
Professor Thorek continues his chapter with:
“ There is no human calling which demands from
those who follow it a greater endowment of the
best human qualities and the highest developments
of technical knowledge and skill than art of sur-
gery.” Further, he writes “On the other hand, the
surgeon’s judgment, knowledge and skill may save
a life otherwise doomed; Erroneous or careless
surgical procedures may and often do bring either
death or life-long misery to a patient who has had
a comparatively easily corrected condition” [2].
I should add to these beautifully written
words, that should guide every surgeon, that
avoiding carelessness and adventurous surgical
behavior is a must for every surgeon, every student of surgery, every member of the surgical
team, irrespective the stage of their surgical life.
The only way to do so, it is for us surgeons to be
prepared well, have utmost respect for every procedure, and know everything that is to know
about the patient, including past surgical history,
the anatomy (often distorted from previous pro-
cedures), physiology and patients state of mind,
and patient’s wishes and goals of end-of-life.
After thoroughly studying Thorek’s comprehensive insights, I have come to appreciate more
the complexity and signicance of surgery, which
has long been regarded as one of the noblest arts.
While surgical decision-making has evolved over
the years, maintaining respect for the patient, disease, and procedures, as well as a commitment to
continuous improvement, remains constant. The
inherent complexity of making surgical decisions
is deeply ingrained in the hearts, minds, and their
beings of surgeons.
The methods of surgical decision-making in
the present day differ from those used in the
past, with technological advancements revolutionizing the eld of medicine and surgery. The
convergence of surgeon intuition, creativity, and
knowledge and comfort with cutting-edge medical technologies has led to a signicant transformation in the practice of surgery. Innovations
such as laparoscopy, robotics, nanotechnology,
genetics, virtual reality, and bioengineering
have reshaped the surgical landscape, empowering patients to actively engage in their own
healthcare and achieve better outcomes. As a
result, hospitals have adapted to support these
advancements, and surgeons have embraced a
patient- centered, disease-focused, technologydriven, and collaborative approach to healthcare
[5, 6].
However, despite the various considerations
discussed in this book, the ultimate decisions
regarding whether to operate, when to operate,
and which approach to take rely solely on the surgeon, and it is a complex interplay of experience
of the surgeon, intuition, education, training,
exposure, and the surgeon’s commitment to providing the best possible care for the patient.
When evaluating the advancements in technology across the spectrum, it is evident that surgical outcomes have improved, leading to
reduced morbidity and mortality rates and a
higher quality of life for patients. However, at its
essence, surgical decision-making transcends
mere evidence-based explanations; it lies at the
heart of being a surgeon. It involves blending
technical expertise with a relentless drive to heal
28 Epilogue: Quo Vadis Surgical Decision-Making
339
patients and a constant willingness to question
and evaluate our own actions.
It is crucial for surgeons to recognize that not
every decision made will be correct, and it is
essential to acknowledge and learn from mistakes
when they occur. True surgical competence
involves an ongoing process of self-reection
and a willingness to continuously strive for
improvement.
To quote again Professor Max Thorek: “To
fail to admit one’s mistakes is to block progress; an honest declaration of error is the rst
step toward its correction. In this age of cooperation in the science of healing, the surgeon
who fears loss of prestige through acknowledgment of fault violates not only faith to himself,
but also unjust to his calling” [7].
Acknowledging potential mistakes in decisionmaking can undoubtedly lead us to discover
new approaches when caring for future patients.
Most importantly, will teach the new generations of surgeons dealing with our own errors,
and learn from such mistakes.
Ultimately, we aspire for this collaborative
effort to motivate others to focus their research
endeavors on this subject. Particularly, experienced surgeons should strive to elucidate their
decision-making processes more effectively.
Integrating discussions on decision-making into
surgical planning and team debriengs could be a
valuable practice for every surgeon, as advocated
by the senior author of this chapter.
As I reect on the conclusion of this journey
that began several years ago, the decision to
embark on the creation of the second edition of
this book lls me with a sense of hope and
renewed creativity. On a very personal note,
among >20 book manuscripts I have been
involved with over the years, this one stands out
as the pinnacle of my satisfaction. Instead of
experiencing fatigue, I found myself energized
and genuinely delighted with the nal result. I
hope that this book has ignited a spark of curiosity and reection in our readers, prompting them
to delve deeper into the intricacies of surgical
decision-making. May it serve as a catalyst for
further research, dialogue, and collaboration
among surgeons, educators, and healthcare professionals, driving us toward excellence and
innovation in the eld of surgery.
In closing, I extend my gratitude to all those
who have contributed to this collective effort and
to the patients who entrust us with their care. The
journey of surgical decision-making is a continuous one, marked by challenges, triumphs, and
opportunities for growth, an often with disappointments, that we never forget, but learn from.
Let us embrace this journey with humility, compassion, and a steadfast commitment to providing
the best possible care for those who place their
trust in our hands.
References
1. Lati R, Lati F.Final thoughts on surgical decision-
making. In: Lati R, editor. Surgical decision making-
beyond the evidence based surgery. Springer; 2016.
2. Thorek M. Modern surgery. Philadelphia: J. P.
Lippincott; 1939. Groves EW. The life and work of
Moynihan. Br Med J 1940;1(4136):601–606.
3. Groves EW.The life and work of Moynihan. Br Med
J. 1940;1(4136):601–6.
4. Groves EW. The life and work of Moynihan: part
II.Br Med J. 1940;1(4137):649–51.
5. Lati R, editor. The modern hospital. Patient centered,
disease based, research oriented, technology driven.
Switzerland AG: Springer Nature; 2019.
6. Lati R, Dudrick SJ, Merrell CR. The new surgeon:
patient-centered, disease-focused, technology-
driven, and team-oriented. In: Lati R, etal., editors.
Technological advances in surgery, trauma and critical
care. New York: Springer Science+Business Media;
2015.
7. Thorek M. Surgical errors and safeguards. 4th ed.
Philadelphia: J.B.Lippincott; 1943.
Index
A
Abbreviated Injury Score (AIS), 277
Abdominal catastrophe, 164
Abdominal closure, 75
Abdominal compartment syndrome, 76
Abdominal injuries, 280, 281
Abdominal wall reconstruction, 140, 141, 151
Abdominal wound contamination, 151
Abdominal wound dehiscence, 106, 122
Academic medicine and surgery, 324
Academic or group practice, 305
ACAS (Atherosclerosis Carotid Artery Study), 253
Acceptance, 302, 303
Acidosis, 134
Acquired coagulopathy of trauma, 134
Active surgical practice, 327
Acute abdominal distention and worsening sepsis, 230
Acute aortic dissection (AAD), 246, 248
Acute blood loss anemia, 72
Acute care surgery
emergency surgery, 105
management of intraoperative surprises, 126–129
surgical emergency care, 105
Acute fracture xation in polytraumatized patients, 85
Acute kidney injury (AKI), 72
etiology, 73
progression, 72
Acute liver failure, 88
Acute mesenteric ischemia, 230
Acute pancreatitis (AP), 203–207, 209
Acute Physiology and Chronic Health Evaluation II
(APACHE II) classication system, 204
Acute Physiology Score (APS), 97
Acute postoperative wound dehiscence, 107
Acute renal failure in trauma cohorts, 87, 88
Acute respiratory distress syndrome (ARDS), 25, 44
Acute Stanford Type A dissection, 246
Acute stress, 43
Acute surgical rectal cancer emergencies, 235
Acute thrombotic MTS, 266
Acute traumatic coagulopathy, 84, 134
Acute type B aortic dissection (aTBAD), 246
Acute upper gastrointestinal bleeding, 209
Acute wound dehiscence, 96
Advanced imaging technologies, 3, 4, 161
Advanced neuromonitoring techniques, 280
Advanced Trauma Life Support (ATLS)
guidelines, 277, 282
protocol, 278
Age-based criteria, 319
Age discrimination, 317, 323
Age Discrimination in Employment Act (ADEA) in
1986, 323
Age-related mandatory retirement, 319
Aggressive blood product replacement with fresh frozen
plasma, 134
Aging, 319
Aging surgeons
behavior, 318
performance, 318, 321
AI algorithms, 5
Air Algerie MD83; EC-LTV, 49
Airlines, safety, 50
Airway-breathing-circulation, 279
Airway management, 278
AKI, see Acute kidney injury (AKI)
Alcohol
consumption and surgeons, 45, 46
and sleep deprivation, 46
on surgical decision making, 25
Alpha Omega Alpha status, 50
ALPPS procedure, see Associating liver partition and
portal vein ligation for staged hepatectomy
(ALPPS) procedure
Alveolar bone, 294, 295
Alveolar process, 292
AMA report, 322
Ambiguous genitalia, 165, 166
American Association for the Surgery of Trauma
(AAST), 214, 216, 308
of solid organ injuries, 281
American Board of Surgery, 323
American Cancer Society, 233
American College of Surgeons, 21, 35, 323
American College of Surgeons Committee on Trauma
guidelines, 84, 282
American College of Surgeons National Surgical Quality
Improvement Program (ACS-NSQIP), 59, 94
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2024
R. Lati (ed.), Surgical Decision-Making, https://doi.org/10.1007/978-3-031-67391-7
341
342
Index
American College of Surgeons Surgical Risk Calculator
(ACS-SRC), 59, 60
American Medical Association, 321, 323
American Society of Anesthesiology (ASA), 59, 206
American Surgical Association, 6
Anastomotic leak, 236
Anesthesia risks, 160
Angioembolization, 84
Angiographic embolization, 184
ANN model, see Articial neural network (ANN) model
Anorectal malformations (ARMs), 162
Anterior cingulate cortex (ACC), 45
Anterior component separation (ACS) technique for
abdominal wall reconstruction, 150
Antibiotic therapy, 111
Antimicrobial therapy, 293
Aortic angioplasty for immediate aortic remodeling in
STABLIZE technique, 249
Aortic false lumen patency status, preoperative
imaging, 250
Aortic remodeling after STABILIZE technique, 252
Aortic valve replacement, 230
Applied ergonomics, 318
Archives of Surgery, 21
Area Under the Curve (AUC), 58
Arterial bleeding, 139
Arterial emboli, 115
Arteriotomy, 255
Articial intelligence (AI), 4, 5, 18, 270
and computer programming in the airline industry, 16
denition, 58
developments, 16
models, 5
non-linear properties, 57
Articial neural network (ANN) model, 62, 65
accuracy, 64
incidental portal-venous phase CT, 65
lymph node metastasis, 65
predictive ANN model, 64
ASA score, see American Society of Anesthesiology (ASA)
Assessment of cognitive functions, 320
Associating liver partition and portal vein ligation for
staged hepatectomy (ALPPS) procedure, 200
stage 1 with reconstruction of left portal vein, 201
Attention and memory processes, 43
ATTRACT trial, 267
Attrition among pilot trainees, 50
Augmented reality (AR) during surgery, 58
Aviation program, 50
Aviation Selection Test Battery (ASTB), 51
Aviators based on performance under psychological
stress, 51
Avulsion, 292
B
Band erosion, 180
Band slippage, 179, 180
Bariatric surgery, 185
benets, 179
complications, 179
nutritional deciencies, 179
population, 94
Baseline imaging evaluation, 250
Bayes, Thomas, 223
Bedside assessments and human intuition in decision-
making process, 5
Bedside exploratory laparotomies, 75
Bedside index for severity and acute pancreatitis
(BISAP) score, 204
Bedside therapeutic interventions, 74
Behavior, information-gathering type, 44
Bilateral craniectomy, 136, 137
Bile duct injuries, 212
Bile duct misidentication, 35
Bile duct reconstructive procedures, 198
Biliary-pancreatic injuries, 138
Biologic mesh reinforcement, 123
Bladder exstrophy and epispadias complex, 169
Bone and joint integrity, 167
Botulinum toxin A (BTA), 149
Brain structures, 20, 44
Branch vessel wire protection and stenting after
completion of aortic remodeling, 252
Breathing, 278
Burnout, 22, 307
causes, 310
consequences, 311
and COVID-19 pandemic, 309
and depression, 310
medical students and residents, 308
phenomenon, 308
prevention in surgeons, 311, 312
signs and symptoms, 310
vs. stress, 308, 309
in surgeons, 309
Burnout syndrome, 307
Burst abdomen, 122, 123
C
CAB (circulation-airway-breathing), 279
Calcied left iliac arterial system, 262
Cancer in elderly patient, 172
Cardiac output (CO), 71
Cardiopulmonary resuscitation (CPR), 73
Carotid endarterectomy
activated clotting time, 255
aggressive retraction, 255
brain physiology, 254
versus carotid artery stenting, 245
cerebral blood ow, 254
continuous EEG monitoring, 254
embolization of atheromatous debris, 255
external jugular vein, 255
historical perspective, 253
post-operative care, 254
preoperative imaging studies, 254
recurrent laryngeal nerve, 255
regional anesthesia, 254
Index
343
regional cervical block, 254
stump pressure, 254
unclamping sequence, 255
Catecholamines, 43
Catheter-directed thrombolysis (CDT), 267
CAVENT trial, 267
Centre for Agroecology, Water and Resilience
(CAWR), 146
The Checklist Manifesto, 31
Chest trauma, 282
Child-Pugh (CPT) classication, 210
Chimeric antigen receptor (CAR)-T cell therapy, 194
Cholangiocarcinoma, 195
Cholecystectomy, 209
in cirrhotic patients, 210
with Mirrizi syndrome, 35
timing, 211
Cholecystostomy, tubes, 211
Choledocholithiasis, 210, 211
Chronic post-dissection TAAA, 249
Chronic thrombotic MTS, 267
Circulation, 278, 279
Civilian trauma management, 279
Clinical cognition, 320
Clinical complexity in pediatric surgical patients, 161
Clinically relevant postoperative pancreatic stula
(CR-POPF), 61
Clinical patient care, 226
Cloacal exstrophy or persistent cloaca, 168
Clot maceration, 266
ClotTriever catheter, 267
ClotTriever device, 267
ClotTriever procedure, 267
Cognitive processes, 53
Cognitive robots, 64
Cognitive task survey, 37
Colon and rectal malignancies
emergency management
acute surgical indications, 233
adjuvant treatment strategies, 235
anastomotic leaks on local recurrence, 236
cancer-related mortality, 233
circulating tumor DNA in recurrence detection
and treatment guidance, 236
clinical obstruction or perforation, 235
closed-loop obstruction, 239
comprehensive care, 234
diagnostic and therapeutic process, 234
evidence-based interventions, 234
extended or multivisceral resections, 234
extracolonic or metastatic lesions, 234
intraoperative complications, 235
intraoperative necessity, 234
lifetime risk, 233
management of acute complications, 242
medical specialties, 236
mid-transverse colon mass, 240
multimodal therapy, 235
neoadjuvant therapy, 235
oncologic integrity, 236
oncologic outcome, 235
optimal resection margin, 235
patient care, 235
patient prognosis, 234
physiological insult, 235
postoperative evaluation, 234
preoperative treatment protocols, 235
preventive measures and early intervention
strategies, 234
proximal and distal transection, 235
quality of life, 235
resection or palliative measures, 235
screening efforts and lifestyle modications, 233
side-to-end anastomosis, 240
sphincter preservation, 235
stent placement, 242
surgical intervention, 235
surgical morbidity and mortality rates, 233–234
surgical, oncologic, and supportive care
strategies, 236
synchronous lesions, 234
treatment approach, 234
tumor removal and functional outcomes, 235
tumor resection, 235
Colon cancer, oncologic resection, 237–239
Colonic stenting, 241
Colorectal liver metastasis, 195
Colorectal surgeries, 4
Common bile duct exploration for stones and iatrogenic
enterotomy, 118
Common bile duct (CBD) injuries, 120, 212
Communication during surgery, 197
Communication dynamics, 54
Compensatory mechanisms, 320
Complex abdominal wall defect, surgical
management, 146
Complex or rare congenital anomalies, 169
Complex surgical procedures, 37
Complicated appendicitis, 164
Complicated inguinal hernias, 164, 165
Complicated skin and soft tissue infections (cSSTIs), 111
Component separation techniques, 150
Comprehension, 53
Computer programming in airline industry, 16
Concomitant injuries, 292
Concussion, 290
Congenital diaphragmatic hernia, 169
Continuous ICU monitoring, 75
Continuous renal replacement therapy (CRRT), 73
central vascular access, 73
types, 73
Continuous venovenous hemodialtration (CVVHDF), 73
Continuous venovenous hemodialysis (CVVHD), 73
Continuous venovenous hemoltration (CVVH), 73
Contusions or minor injuries, 214
Convolutional neural network (CNN), 65
Coping strategies, 304, 305
Coronary artery bypass procedure, 330
COVID-19 and aspiration pneumonia, 73
Craniofacial malformations, 169
344
Index
Creativity in complex surgical procedures, 18
Critical illness on gut function, 77
Crown fractures, 296
CRRT, see Continuous renal replacement therapy (CRRT)
Crystalloid resuscitation, 134
Cystic lesion in pancreatic head, 200
D
Damage control
for abdominal catastrophes and sepsis, 141
concepts and techniques, 133
in vascular surgery, 139
Damage control laparotomy (DCL), 138, 139, 279, 280
Damage control on demand, 149
Damage-control open cavity approach to hemostasis and
source control, 69
Damage control orthopedics (DCO) concepts, 139, 283
Damage control surgery (DCS), 85, 97, 116
abbreviated laparotomy, 134
abdominal closure, 134
acute abdominal compartment syndrome, 135
complete denitive surgery, 135
decision making–process, 133
direct peritoneal resuscitation, 133
embolization, 133
during emergency resuscitative thoracotomy, 137
hemodynamic instability, 135
indications, 135
initial evaluation and management, 134
intra-abdominal hemorrhage, 135
lethal diamond, 133
long-term recovery, 133
management, 133
of severely injured patients, 134
multiple or complex injuries, 135
patient’s physiology, 133
physiological deterioration, 137
physiological exhaustion, 137
prolonged hypotension, 134
prolonged surgery time, 135
resuscitation strategies, 134
soft tissue damage, 135
surgical practice, 133
surgical procedure, 133
temporary mobilization for severe bone fractures, 133
in thoracic trauma, 137, 138
trauma induced hypocalcemia, 133
Damage control surgery in thoracic trauma (DCTS), 137
Data analytics, 4
Data collection process, 5
Data-driven strategic timing of uid administration and
removal, 70
da Vinci Surgical System, 3
DCS, see Damage control surgery (DCS)
Decision making process, 159, 330
analysis concepts, 53
around surgical critical care, 86–88
in general surgery, 222–224
identical pathway or algorithm, 316
misadventures, 316
operative errors, 316
pathologic situation, 317
surgical management, 316
in survivors of MOF, 88
therapeutic plan, 316
Decision-tree diagrams, 33
Decompressive craniectomy (DC), 136, 280
combined with standard care, 136
Deep learning (DL), 58
Denitive abdominal wall reconstruction, 149, 150
surgical decision making-process
clinical entity, 145
continuum of care, 146
disciplined protocols, 145
intestinal obstruction, 146
itinerary surgeon, 145
management, 145
outside surgical dogma or box, 145
postoperative restulization, 146
surgical approach, 145
well-planned surgical strategy, 145
Denitive (injury repair) operation, 140
Denitive reconstruction technique, 146, 147
Delaying surgery, 146
Dental hard tissues, 293, 294
Dentoalveolar trauma
analytic classication, 290
classication system, 290
decision making, 289
denitive treatment during emergency, 289
emergency management, 293
etiologies, 289
principles, 293
surgical decision making, 289
types of facial trauma, 289
DENTOSAFE (Dental Rescue Box for Storing Tooth or
Tooth Fragments), 294
Denver group, 84
Denver score, 83
Dialysis, 72
Difcult cholecystectomy, 118–120
Difcult gallbladder, management, 209, 210
Difcult hernia repair, 125, 126
Digital decision support systems (DSS), 4
Direct patient care, 301
Direct peritoneal resuscitation (DPR), 75, 76, 116
Disability status, patients, 279
Discretionary procedure, 227
Discrimination against the elderly, 319
Dislocated teeth, repositioning, 294
Disrupt BTK study, 263
DISRUPT PAD I and II, 261
DISRUPT PAD III observational study, 262, 263
DISRUPT PAD III RCT and OS trials, 262, 263
Dissection stenting, 247
Distal esophageal pouches, 163
Distal pancreatectomy, 215
Distal transection, 240
Diverting loop ileostomy, 240