Air, blood, lymph and food pass through the normal thorax at highly variable rates and pressures. Chest injuries and diseases regularly derange many critical body systems and functions. A Manual of Thoracic Surgery opens its detailed and practical discussion of thoracic physiology and thoracic surgery by reviewing all that the mere observation of a closed chest drainage system can reveal. This book was written for those who wish to understand more, and memorize less, about why they do what they do for their patients. It remains an internationally respected source of useful clinical insights on a wide range of surgical conditions.
Background, Purpose and Approach
Chest surgeons regularly assimilate new therapeutic concepts and technological advances. They routinely perform complex operative procedures with many sequential steps. And they repeatedly acquire new surgical techniques during post-graduate seminars and brief fellowships.
Surgeons now in their 30's to 50's trained at a time when common thoracic surgical procedures were often routinely successful. But routine success has its own problems, as patients develop unrealistic expectations and surgeons become entrapped by technically demanding surgical procedures they have inherited. For even routine procedures sometimes go astray. And many operations in and about the chest remain far from routine.
Yet under clinically threatening circumstances, many surgeons are reluctant to modify or relinquish their time-honored approaches. For those who have had no part in developing current procedures cannot always be sure why certain steps have become a part of their routine. Consequently, they feel pressured to do it the same way every time - even when circumstances might suggest something more appropriate - because any change could prove harmful and hard to defend.
Countless surgical authorities and many surgical textbooks tell the surgeon how to operate in and about the chest. Some try to explain why things should be done in a certain fashion. But while surgical authorities regularly disagree on technical matters, many cannot clarify (and some do not know) which steps are essential and which represent the irrelevant residue of long-abandoned routines.
Modern surgical practices evolved over centuries. They arose through countless episodes of trial and error, over innumerable dead bodies, amidst fervent vows that "I'll never do that again!". Indeed, it could not be otherwise. For surgical operations are often performed under emergency conditions. Even elective surgery proceeds without complete knowledge of the patient. And if one day it should become possible to obtain such complete knowledge (without performing an autopsy) it will still be impractical to acquire and utilize all of that information.
Every surgical advance is eventually confirmed or discredited as individual surgeons observe individual operative outcomes. Surgical operations always involve many known and unknown variables. Hence good ideas are sometimes abandoned prematurely because a poor result was caused by an unrelated variable. And useless or even harmful irrelevancies sometimes persist unless clearly detrimental.
These systemic difficulties, and innumerable individual idiosyncrasies, explain why different training programs generate so many different approaches to apparently identical surgical problems. They also explain why those who teach surgery - having suffered many disastrous outcomes - tend to view plausible but personally untested ideas or modifications with suspicion. So in the interests of patient safety and surgical efficiency, most surgical programs encourage those in training to "do it the same way every time".
And that is what makes von Hippel's Manual so useful. For this book carefully and completely clarifies how, when and why a simple alternative approach could save the day. So while A Manual of Thoracic Surgery is no guide to the latest technological advances, it can certainly help those involved in thoracic surgery as they review, consolidate, upgrade and utilize more effectively the information they already possess about chest injuries and diseases.
Competence in closed chest drainage remains central to adequate postoperative care of the thoracic surgical patient. This text deals with thoracic physiology and thoracic surgery as they relate to closed chest drainage. It is designed to correct common and dangerous misconceptions that often threaten the patient who has a thoracic derangement. No attempt is made to be comprehensive or up to the minute, or to provide material from other texts or reveal the "one true way" (unless so stated).
If I have not diagnosed and treated it successfully, I will not tell you how. Where my results are questionable or relevant, I will provide them. If my approach seems simplistic, I can only say, "It has worked for me."
I have tried to build from basics without dwelling on them overlong, as an idea painfully obvious to one surgeon may be the missing link for another. It is hoped that less experienced or more highly specialized thoracic surgeons will find here some concepts or methods that can expedite or simplify their work and make it even more successful.Review:
"...Le desir de l'auteur est de faire profiter de sa longue et large experience chirurgien thoracique et d'indiquer au fur et a mesure les pleges tendus par cette pathologie particuliere et les moyens de les eviter....
"Le lecteur sera egalement interesse par les pages consacrees au diaphragme, a la paroi thoracique, au mediastin, au poumon lui-meme et aux soins postoperatoires qui font de l'ouvrage un tout claire et coherent, susceptible d'interesser tous les chirurgiens et les anesthesistes reanimateurs...." -- Annales de Cardiologie et D'Angeiologie
"I highly recommend this book to all current thoracic surgery housestaff, recent graduates and nurses responsible for the care of patients with chest tubes." -- Annals of Thoracic Surgery
"This ... Manual includes diagnosis and methods of treatment of thoracic surgical disorders as well as the principles of pleural drainage. The book is refreshing reading because instead of a review of the literature, it relates one man's personal experience in the thoracic surgical field. Many of the routine but essential concepts of thoracic surgery that surgeons rarely give thought to are presented." -- Alfred J. Tector, M.D.
"This little book is a mine of useful information for the management of all aspects of disease, injury, and surgery to the diaphragm, chest wall, lung, pleura and pericardium. Many aspects of chest surgery, which are so puzzling to the nurse, and the doctor just beginning his experience in a thoracic unit, are dealt with most clearly and completely. This is a very valuable book for any thoracic surgery unit to keep on its shelves for reference by members of the unit and the reviewer feels sure that it would be used very frequently. -- The Australian and New Zealand Journal of Surgery
Descrizione libro Stone Age Pr, 1986. Paperback. Condizione libro: New. Codice libro della libreria P11096158081X
Descrizione libro Stone Age Pr. PAPERBACK. Condizione libro: New. 096158081X New Condition. Codice libro della libreria NEW6.3470721