Schein's Common Sense: Prevention and Management of Surgical Complications: for Surgeons, Residents, Lawyers, and Even Those Who Never Have Any Complications

576 Pages·2013·6.12 MB·English

by  Moshe Schein

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SCHEIN’S COMMON SENSE
Schein’s books are always terrific reads, conveying pithy observations and
practical advice and doing so with wit and scholarship. This latest is surely
Prevention and Management
a must for every surgeon’s bookshelf.
Abraham Verghese MD, author of CUTTING FOR STONE of Surgical Complications
Look at this image: do you understand the surgeon’s distress?We know Fo Sc For surgeons, residents, lawyers, and even
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This book will help you, and your patients, avoid the misery of
complications, and will provide advice on the management of those that
are unavoidable. Like our previous international bestseller Schein’s
Common Sense Emergency Abdominal Surgery, you will find that this book
is rather informal – and definitely not politically correct: what is considered
Danny Rosin, Tel Aviv
taboo by others is not taboo for us; here we discuss everything!
Moshe Schein
Moshe Schein
ISBN 978-1-903378-93-9 Paul N. Rogers
Ari Leppäniemi Paul N. Rogers
Danny Rosin
Ari Leppäniemi
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Danny Rosin
9 781903 378939
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SCHEIN’S COMMON SENSE
Prevention and Management
of Surgical Complications
For surgeons, residents, lawyers, and even
those who never have any complications
Moshe Schein MD FACS
Paul N. Rogers MBChB MBA MD FRCS
Ari Leppäniemi MD
Danny Rosin MD
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Schein’s Common Sense Prevention and Management of Surgical Complications
tfm Publishing Limited, Castle Hill Barns, Harley, Nr Shrewsbury, SY5 6LX, UK
Tel: [phone]; Fax: [phone]
E-mail: [email protected];
Web site: www.tfmpublishing.com
Design & Typesetting: Nikki Bramhill BSc Hons Dip Law
First edition: © October 2013
Cartoons: © 2013 Evgeniy E. (Perya) Perelygin, MD
Front and back cover paintings: © 2013 Dan Schein (www.danschein.com)
“Before the operation” and “The mortality”: oil on canvas
Paperback ISBN: 978-1-903378-93-9
E-book editions: 2014
ePub ISBN: 978-1-903378-96-0
Mobi ISBN: 978-1-903378-97-7
Web pdf ISBN: 978-1-903378-98-4
The entire contents of Schein’s Common Sense Prevention and Management of
Surgical Complications is copyright tfm Publishing Ltd. Apart from any fair
dealing for the purposes of research or private study, or criticism or review, as
permitted under the Copyright, Designs and Patents Act 1988, this publication
may not be reproduced, stored in a retrieval system or transmitted in any form or
by any means, electronic, digital, mechanical, photocopying, recording or
otherwise, without the prior written permission of the publisher.
Neither the authors, the editors nor the publisher can accept responsibility for
any injury or damage to persons or property occasioned through the
implementation of any ideas or use of any product described herein. Neither
can they accept any responsibility for errors, omissions or misrepresentations,
howsoever caused.
Whilst every care is taken by the authors, the editors and the publisher to ensure
that all information and data in this book are as accurate as possible at the time
of going to press, it is recommended that readers seek independent verification
of advice on drug or other product usage, surgical techniques and clinical
processes prior to their use.
The authors, editors and publisher gratefully acknowledge the permission
granted to reproduce the copyright material where applicable in this book.
Every effort has been made to trace copyright holders and to obtain their
permission for the use of copyright material. The publisher apologizes for any
errors or omissions and would be grateful if notified of any corrections that
should be incorporated in future reprints or editions of this book.
Printed by Gutenberg Press Ltd., Gudja Road, Tarxien, PLA 19, Malta
ii Tel: [phone]; Fax: [phone]
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Contents
Contributors vii
Foreword x
Editors’ note xi
Preface xiii
Dedications xvi
PART I — GENERAL CONSIDERATIONS 1
Chapter 1 3
What are complications?
Definitions, classification and ruminations
Moshe Schein, Paul N. Rogers, Ari Leppäniemi and Danny Rosin
Chapter 2 13
Preventing morbidity and mortality (M&M): general principles
Moshe Schein, Paul N. Rogers, Ari Leppäniemi and Danny Rosin
Chapter 3 39
Hemostasis and bleeding
Samir Johna and Moshe Schein
Chapter 4 57
Postoperative infections
Moshe Schein
Chapter 5 77
The wound, the wound…
Moshe Schein, Paul N. Rogers, Ari Leppäniemi and Danny Rosin
iii
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Schein’s Common Sense Prevention and Management of Surgical Complications
Chapter 6 91
Leaking gastrointestinal anastomoses
Section 1. Basic considerations 91
Moshe Schein
Section 2. The esophagus 106
John Hunter
Section 3. Stomach and duodenum 116
Wen-hao Tang
Section 4. Small intestine 128
Moshe Schein and Mark Cheetham
Section 5. Large bowel and rectum 134
Caitlin W. Hicks and Jonathan E. Efron
Chapter 7 145
Abdominal wall dehiscence
Moshe Schein, Paul N. Rogers, Ari Leppäniemi and Danny Rosin
Chapter 8 155
Ileus and early postoperative small bowel obstruction (EPSBO)
Moshe Schein
Chapter 9 169
Minimal access surgery
Danny Rosin
Chapter 10 183
Dealing with patients, families, lawyers and yourself
Avi Rubinstein and Moshe Schein
Chapter 11 203
The developing ('Third') World
B. Ramana
Chapter 12 217
Going to the country: the rural situation
Moshe Schein
iv
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Contents
PART II — SPECIFIC CONSIDERATIONS 229
Chapter 13 231
The Intensive Care Unit (ICU)
Ronald V. Maier
Chapter 14 257
Colon and rectum (and the humble anus)
Mark Cheetham
Chapter 15 291
Hernias
Danny Rosin
Chapter 16 315
The gallbladder and bile ducts
Danny Rosin, Paul N. Rogers and Moshe Schein
Chapter 17 345
The appendix
Moshe Schein
Chapter 18 361
The pancreas
Gregory Sergeant, Mickaël Lesurtel and Pierre-Alain Clavien
Chapter 19 377
The liver
Erik Schadde and Pierre-Alain Clavien
Chapter 20 393
The breast
Danny Rosin
Chapter 21 413
The thyroid, parathyroid and adrenal glands
Saba Balasubramanian
v
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Schein’s Common Sense Prevention and Management of Surgical Complications
Chapter 22 431
Vascular surgery
Paul N. Rogers
Chapter 23 451
Bariatric surgery
Ahmad Assalia
Chapter 24 471
Trauma
Ari Leppäniemi
Chapter 25 497
Pediatric surgery
Graeme Pitcher
Chapter 26 519
Urology
Zohar A. Dotan
Epilogue 535
Lessons learned from surgical complications
David Dent
Index 539
vi
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Contributors
Ahmad Assalia MD Chief of Advanced and Bariatric Surgery, Rambam
Health Care Campus, Haifa, Israel ( Chapter 23)
[email protected]
Saba Balasubramanian MS FRCS PhD Consultant Endocrine Surgeon,
Royal Hallamshire Hospital, Sheffield, UK ( Chapter 21)
[email protected]
Mark Cheetham BSc MD FRCS Consultant General and Colorectal
Surgeon, Royal Shrewsbury Hospital, Shrewsbury, Shropshire, UK (
Chapters 6 and 14)
[email protected]
Pierre-Alain Clavien MD PhD FACS FRCS (Ed.) Professor and Chairman
of Surgery, Swiss HPB Center, Department of Surgery, University Hospital
Zurich, Zurich, Switzerland ( Chapters 18 and 19)
[email protected]
David Dent ChM FRCS (Eng) FCS(SA) FRCP&S (Glas. Hon) Emeritus
Professor of Surgery, University of Cape Town, South Africa ( Epilogue)
[email protected]
Zohar A. Dotan MD PhD Head of Uro-oncology Service, Department of
Urology, Sheba Medical Center, Tel Hashomer, Israel ( Chapter 26)
[email protected]
Jonathan E. Efron MD FACS FASCRS Associate Professor of Surgery, The
Mark M. Ravitch MD Endowed Professorship in Surgery; Chief, Ravitch
Division, Johns Hopkins University, Baltimore, Maryland, USA ( Chapter 6,
section 5)
[email protected]
Caitlin W. Hicks MD MS Resident in Surgery, Johns Hopkins Hospital,
Baltimore, Maryland, USA ( Chapter 6, section 5)
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Schein’s Common Sense Prevention and Management of Surgical Complications
John Hunter MDFACS Mackenzie Professor and Chairman of Surgery,
Oregon Health & Science University, Portland, Oregon, USA ( Chapter 6,
section 2)
[email protected]
Samir Johna MD FACS FICS Staff Surgeon, Southern California Permanente
Medical Group; Clinical Professor of Surgery, Loma Linda University School
of Medicine; Director, Arrowhead Regional — Kaiser Fontana General
Surgery Residency Program, California, USA ( Chapter 3)
[email protected]
Ari Leppäniemi MD Head of Trauma and Emergency Surgery, University of
Helsinki, Finland ( Chapters 1, 2, 5, 7 and 24)
[email protected]
Mickaël Lesurtel MD PhD SNF Förderungsprofessor, Swiss HPB Center,
Department of Surgery, University Hospital Zurich, Zurich, Switzerland (
Chapter 18)
[email protected]
Ronald V. Maier MD FACS Jane and Donald D. Trunkey Professor and Vice-
Chair of Surgery, University of Washington; Surgeon-in-Chief, Harborview
Medical Center, Seattle, USA ( Chapter 13)
[email protected]
Graeme Pitcher MD FACS Pediatric Surgeon, Associate Professor of
Surgery, University of Iowa, Iowa City, USA ( Chapter 25)
[email protected]
B. Ramana MS DNB FRCS Advanced Laparoscopic & Bariatric Surgeon,
BMI (Bariatrics & Metabolism Initiative), Belle Vue Clinic, Kolkata, India (
Chapter 11)
[email protected]
Paul N. Rogers MBChB MBA MD FRCS Consultant General and Vascular
Surgeon, Western Infirmary, Glasgow, UK ( Chapters 1, 2, 5, 7, 16 and 22)
[email protected]
viii
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Contributors
Danny Rosin MD Attending General and Advanced Laparoscopic Surgeon,
Sheba Medical Center, University of Tel Aviv, Israel ( Chapters 1, 2, 5, 7,
9, 15, 16 and 20)
[email protected]
Avi Rubinstein MD MSc Neurosurgeon, Advocate, Law Offices Rubinstein-
Yakirevtch, Ramat Gan, Israel ( Chapter 10)
[email protected]
Erik Schadde MD FACS Director HPB Fellowship, Swiss HPB Center,
Department of Surgery, University Hospital Zurich, Zurich, Switzerland (
Chapter 19)
[email protected]
Moshe Schein MD FACS General Surgeon, Marshfield Clinic, Ladysmith,
Wisconsin, USA ( Chapters 1-8, 10, 12, 16 and 17)
[email protected]
Gregory Sergeant MD PhD HPB Fellow, Swiss HPB Center, Department of
Surgery, University Hospital Zurich, Zurich, Switzerland ( Chapter 18)
[email protected]
Wen-hao Tang MD PhD Professor & Chief Surgeon, Zhongda Hospital,
Southeast University, Nanjing, P. R. China ( Chapter 6, section 3)
[email protected]
ix