Sabiston Textbook of Surgery. The Biological Basis of Modern Surgical Practice

2136 Pages·2016·410.06 MB·English

by  Courtney M. Townsend

SABI STON

of
TEXTBOOK
SURGERY
The BIOLOGICAL BASIS of
MODERN SURGICAL PRACTICE
SABI STON
of
T EXT BOOK

SURGE RY
The BIOLOGICAL BASIS of
MODERN SURGICAL PRACTICE
20
TH EDITION
COURTNEY M. TOWNSEND, JR., MD B. MARK EVERS, MD
Professor Professor and Vice-Chair for Research, Department of Surgery
Robertson-Poth Distinguished Chair in General Surgery Director, Lucille P. Markey Cancer Center
Department of Surgery Markey Cancer Foundation Endowed Chair
University of Texas Medical Branch Physician-in-Chief, Oncology Service Line UK Healthcare
Galveston, Texas University of Kentucky
Lexington, Kentucky
R. DANIEL BEAUCHAMP, MD
KENNETH L. MATTOX, MD
J.C. Foshee Distinguished Professor and Chairman, Section of
Surgical Sciences Professor and Vice Chairman
Professor of Surgery and Cell and Developmental Biology and Michael E. DeBakey Department of Surgery
Cancer Biology Baylor College of Medicine
Vanderbilt University School of Medicine Chief of Staff and Chief of Surgery
Surgeon-in-Chief, Vanderbilt University Hospital Ben Taub General Hospital
Nashville, Tennessee Houston, Texas
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
ISBN: 978-0-323-29987-9
International Edition ISBN: 978-0-323-40162-3
Copyright © 2017 by Elsevier, Inc. All rights reserved.
Copyright 2012, 2008, 2004, 2001, 1997, 1991, 1986, 1981, 1977, 1972, 1968, 1964, 1960, 1956 by
Saunders, an imprint of Elsevier Inc.
Copyright 1949, 1945, 1942, 1939, 1936 by Elsevier Inc.
Copyright renewed 1992 by Richard A. Davis, Nancy Davis Reagan, Susan Okum, Joanne R. Artz, and
Mrs. Mary E. Artz.
Copyright renewed 1988 by Richard A. Davis and Nancy Davis Reagan.
Copyright renewed 1977 by Mrs. Frederick Christopher.
Copyright renewed 1973, 1970, 1967, 1964 by W.B. Saunders Company.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and retrieval system,
without permission in writing from the publisher, except that, until further notice, instructors requiring their
students to purchase Sabiston Textbook of Surgery by Courtney M. Townsend, Jr., MD, may reproduce the contents
or parts thereof for instructional purposes, provided each copy contains a proper copyright notice as follows:
Copyright © 2017 by Elsevier Inc.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom they
have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient,
and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.
Please change to the following:
Library of Congress Cataloging-in-Publication Data
Sabiston textbook of surgery : the biological basis of modern surgical practic / [edited by] Courtney M. Townsend,
Jr, R. Daniel Beauchamp, B. Mark Evers, Kenneth L. Mattox.—20th edition.
p. ; cm.
Textbook of surgery
Preceded by Sabiston textbook of surgery / [edited by] Courtney M. Townsend Jr. … [et al.]. 19th ed. 2012.
Includes bibliographical references and index.
ISBN 978-0-323-29987-9 (hardcover : alk. paper)—ISBN 978-0-323-40162-3 (international edition : alk. paper)
I. Townsend, Courtney M., Jr., editor. II. Beauchamp, R. Daniel, editor. III. Evers, B. Mark, 1957-,
editor. IV. Mattox, Kenneth L., 1938-, editor. V. Title: Textbook of surgery.
[DNLM: 1. Surgical Procedures, Operative. 2. General Surgery. 3. Perioperative Care. WO 500]
RD31
617—dc23
2015035365
Executive Content Strategist: Michael Houston
Content Development Specialist: Joanie Milnes
Publishing Services Manager: Patricia Tannian
Senior Project Manager: Cindy Thoms
Book Designer: Renee Duenow
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To our patients, who grant us the privilege of practicing our craft;
to our students, residents, and colleagues, from whom we learn;
and to our wives—Mary, Shannon, Karen, and June—without
whose support this would not have been possible.
C O N T R I B U T O R S
Cary B. Aarons, MD Faisal G. Bakaeen, MD, FACS
Assistant Professor of Clinical Surgery Staff Surgeon
University of Pennsylvania Department of Thoracic and
Philadelphia, Pennsylvania Cardiovascular Surgery
Heart and Vascular Institute
Andrew B. Adams, MD, PhD Cleveland, Ohio
Assistant Professor Adjunct Professor
Emory Transplant Center The Michael E. DeBakey Department of Surgery
Department of Surgery Baylor College of Medicine
Emory University School of Medicine Houston, Texas
Atlanta, Georgia
Philip S. Barie, MD, MBA, FIDSA, FACS, FCCM
Charles A. Adams, Jr., MD Professor of Surgery and Public Health
Chief Weill Cornell Medical College
Division of Trauma and Surgical Critical Care New York, New York
Rhode Island Hospital
Associate Professor of Surgery B. Timothy Baxter, MD
Alpert Medical School of Brown University Vice-Chairman, Department of Surgery
Providence, Rhode Island Professor, Vascular Surgery
Department of Surgery
Ahmed Al-Mousawi, MD University of Nebraska Medical Center
Shriners Hospitals for Children Omaha, Nebraska
Department of Surgery
University of Texas Medical Branch R. Daniel Beauchamp, MD
Galveston, Texas J.C. Foshee Distinguished Professor and Chairman
Section of Surgical Sciences
Jatin Anand, MD Professor of Surgery and Cell and Developmental Biology and
Resident in Cardiothoracic Surgery Cancer Biology
Division of Cardiovascular and Thoracic Surgery Vanderbilt University School of Medicine
Department of Surgery Surgeon-in-Chief
Duke University Medical Center Vanderbilt University Hospital
Durham, North Carolina Nashville, Tennessee
Nancy Ascher, MD, PhD Yolanda Becker, MD, FACS
Professor and Chair Professor and Director of Kidney and Pancreas Transplant
Department of Surgery Division of Transplantation
University of California at San Francisco Department of Surgery
San Francisco, California University of Chicago
Pritzker School of Medicine
Stanley W. Ashley, MD Chicago, Illinois
Chief Medical Officer and Senior Vice President for Medical Affairs
Brigham and Women’s Hospital Joshua I.S. Bleier, MD
Frank Sawyer Professor of Surgery Program Director
Harvard Medical School Division of Colon and Rectal Surgery
Boston, Massachusetts University of Pennsylvania Health System
Associate Professor of Clinical Surgery
Paul S. Auerbach, MD University of Pennsylvania
Professor of Emergency Medicine Philadelphia, Pennsylvania
Redlich Family Professor
Stanford University Howard Brody, MD, PhD
Stanford, California Former Director
Institute for the Medical Humanities
Brian Badgwell, MD University of Texas Medical Branch
Associate Professor of Surgery Galveston, Texas
MD Anderson Cancer Center
Houston, Texas
vviiii
Contributors
Carlos V.R. Brown, MD, FACS John D. Christein, MD
Associate Professor and Vice Chairman of Surgery Associate Professor
University of Texas Southwestern—Austin Department of Surgery
Trauma Medical Director University of Alabama School of Medicine
University Medical Center Brackenridge Birmingham, Alabama
Austin, Texas
Dai H. Chung, MD
Bruce D. Browner, MD, MS Professor and Chairman
Gray-Gossling Chair Janie Robinson and John Moore Lee Chair
Professor and Chairman Emeritus Department of Pediatric Surgery
Department of Orthopaedic Surgery Vanderbilt University Medical Center
University of Connecticut Nashville, Tennessee
Farmington, Connecticut
Director William G. Cioffi, MD
Department of Orthopaedics Chief
Hartford Hospital Department of Surgery
Hartford, Connecticut Rhode Island Hospital
Professor and Chairman of Surgery
Brian B. Burkey, MD Alpert Medical School of Brown University
Vice-Chairman Providence, Rhode Island
Head and Neck Institute
Cleveland Clinic Michael Coburn, MD
Cleveland, Ohio Professor and Chairman
Scott Department of Urology
Joshua Carson, MD Baylor College of Medicine
Shriners Hospitals for Children Houston, Texas
Department of Surgery
University of Texas Medical Branch Carlo M. Contreras, MD
Galveston, Texas Assistant Professor of Surgery
University of Alabama at Birmingham
Steven N. Carter, MD Birmingham, Alabama
Clinical Assistant Professor of Surgery
Department of Surgery Lorraine D. Cornwell, MD
University of Oklahoma Health Sciences Center Assistant Professor
Oklahoma City, Oklahoma Cardiothoracic Surgery
Baylor College of Medicine
Howard C. Champion, MD Michael E. DeBakey VA Medical Center
Professor of Surgery Houston, Texas
Uniformed Service University of the Health Sciences
Bethesda, Maryland Marion E. Couch, MD, PhD, MBA, FACS
Richard T. Miyamoto Professor and Chair of Head and Neck Surgery
Faisal Cheema, MD, FACS Physician Executive
Assistant Professor Surgical Services for IU Health Physicians
Division of Vascular Surgery and Endovascular Therapy Indiana University School of Medicine
Department of Surgery Indianapolis, Indiana
University of Texas Medical Branch
Galveston, Texas Merril T. Dayton, MD
Salt Lake City, Utah
Charlie C. Cheng, MD, FACS
Assistant Professor Bradley M. Dennis, MD
Division of Vascular Surgery and Endovascular Therapy Assistant Professor of Surgery
Department of Surgery Division of Trauma and Surgical Critical Care
University of Texas Medical Branch Department of Surgery
Galveston, Texas Vanderbilt University Medical Center
Nashville, Tennessee
Kenneth J. Cherry, MD
Edwin P. Lehman Professor of Surgery
Division of Vascular and Endovascular Surgery
University of Virginia Medical Center
Charlottesville, Virginia
viii
Contributors
Sohum K. Desai, MD James S. Economou, MD, PhD
Resident Beaumont Professor of Surgery
Division of Neurosurgery Professor of Microbiology, Immunology, and Molecular Genetics
Department of Surgery Professor of Medical and Molecular Pharmacology
University of Texas Medical Branch University of California—Los Angeles
Galveston, Texas Los Angeles, California
Rajeev Dhupar, MD, MBA E. Christopher Ellison, MD
Assistant Professor Professor
Department of Cardiothoracic Surgery Department of Surgery
Division of Thoracic and Foregut Surgery Ohio State University
University of Pittsburgh Medical Center Columbus, Ohio
Pittsburgh, Pennsylvania
Stephen R.T. Evans, MD
Jose J. Diaz, MD, CNS, FACS, FCCM Professor of Surgery
Professor of Surgery Georgetown University Medical Center
Chief Acute Care Surgery Executive Vice President and Chief Medical Officer
R. Adams Cowley Shock Trauma Center MedStar Health
University of Maryland Medical Center Washington, DC
Baltimore, Maryland
B. Mark Evers, MD
Zachary C. Dietch, MD Professor and Vice-Chair for Research
Department of Surgery Department of Surgery
The University of Virginia Health System Director
Charlottesville, Virginia Lucille P. Markey Cancer Center
Markey Cancer Foundation Endowed Chair
Roger Dmochowski, MD, MMHC, FACS Physician-in-Chief
Professor of Urology Oncology Service Line UK Healthcare
Director, Pelvic Medicine and Reconstruction Fellowship University of Kentucky
Department of Urology Lexington, Kentucky
Professor of Obstetrics and Gynecology
Vice Chair, Section of Surgical Sciences Grant Fankhauser, MD
Vanderbilt University Medical Center Assistant Professor
Associate Director of Quality and Safety Division of Vascular Surgery and Endovascular Therapy
Executive Director of Risk Prevention Department of Surgery
Vanderbilt Health System University of Texas Medical Branch
Executive Medical Director for Patient Safety and Quality (Surgery) Galveston, Texas
Associate Chief of Staff
Medical Director of Risk Management Farhood Farjah, MD, MPH
Vanderbilt University Hospital Division of Cardiothoracic Surgery
Nashville, Tennessee Surgical Outcomes Research Center
University of Washington
Vikas Dudeja, MD Seattle, Washington
Assistant Professor
Division of Surgical Oncology Celeste C. Finnerty, PhD
Department of Surgery Shriners Hospitals for Children
University of Miami Department of Surgery
Miller School of Medicine Sealy Center for Molecular Medicine
Miami, Florida Institute for Translational Sciences
University of Texas Medical Branch
Quan-Yang Duh, MD Galveston, Texas
Professor of Surgery
University of California—San Francisco Nicholas A. Fiore II, MD
Surgical Service Private Practice
San Francisco VA Medical Center Houston, Texas
San Francisco, California
David R. Flum, MD, MPH
Timothy J. Eberlein, MD Professor and Association Chair for Research Surgery
Bixby Professor and Chairman Director, Surgical Outcomes Research Center
Department of Surgery University of Washington
Spencer T. and Ann W. Olin Distinguished Professor Seattle, Washington
Director, Alvin J. Siteman Cancer Center
Washington University School of Medicine
St. Louis, Missouri ix
Contributors
Yuman Fong, MD John B. Hanks, MD
Chairman C. Bruce Morton Professor and Chief
Department of Surgery Division of General Surgery
City of Hope Medical Center Department of Surgery
Duarte, California University of Virginia
Charlottesville, Virginia
Mandy Ford, PhD
Associate Professor Laura R. Hanks, MD
Emory Transplant Surgery Resident in Obstetrics and Gynecology
Department of Surgery Department of Obstetrics and Gynecology
Emory University School of Medicine University of Rochester
Atlanta, Georgia School of Medicine and Dentistry
Rochester, New York
Charles D. Fraser, Jr., MD
Chief and The Donovan Chair in Congenital Heart Surgery Jennifer W. Harris, MD
Surgeon-in-Chief, Texas Children’s Hospital General Surgery Resident
Professor of Surgery and Pediatrics Post-Doctoral Research Fellow
Susan V. Clayton Chair in Surgery Markey Cancer Center
Baylor College of Medicine Lexington, Kentucky
Houston, Texas
Jennifer A. Heller, MD
Julie A. Freischlag, MD Assistant Professor of Surgery
Professor of Surgery Director
Vice Chancellor Johns Hopkins Vein Center
Human Health Services Department of Surgery
Dean, School of Medicine Johns Hopkins Medical Institutions
University of California—Davis Baltimore, Maryland
Sacramento, California
Jon C. Henry, MD
Gerald M. Fried, MD, CM, FRCSC, FACS Fellow
Edward W. Archibald Professor and Chairman of Surgery Vascular Surgery
McGill University University of Pittsburgh Medical Center
Montreal, Quebec, Canada Pittsburgh, Pennsylvania
Robert D. Fry, MD Antonio Hernandez, MD
Emilie and Roland DeHellebranth Professor of Surgery Emeritus Associate Professor
University of Pennsylvania Department of Anesthesiology
Philadelphia, Pennsylvania Vanderbilt University Medical Center
Nashville, Tennessee
Nasrin Ghalyaie, MD
Assistant Professor of Surgery David N. Herndon, MD, FACS
Department of Surgery Chief of Staff
University of Arizona College of Medicine Shriners Hospitals for Children
Tucson, Arizona Department of Surgery
University of Texas Medical Branch
S. Peter Goedegebuure, PhD Galveston, Texas
Research Associate Professor
Department of Surgery Martin J. Heslin, MD, MSHA
Washington University School of Medicine Professor and Director
St. Louis, Missouri Division of Surgical Oncology
Department of Surgery
Oliver L. Gunter, MD, MPH University of Alabama at Birmingham
Associate Professor of Surgery Birmingham, Alabama
Division of Trauma and Surgical Critical Care
Vanderbilt University School of Medicine Asher Hirshberg, MD
Nashville, Tennessee Director of Emergency Vascular Surgery
Kings County Hospital Center
Jennifer L. Halpern, MD Brooklyn, New York
Assistant Professor
Department of Orthopaedic Surgery
Vanderbilt Orthopaedic Institute
Nashville, Tennessee
x
Contributors
Wayne Hofstetter, MD Marc G. Jeschke, MD, PhD, FACS, FCCM, FRCS(c)
Professor of Surgery Director, Ross Tilley Burn Centre
Deputy Chair Department of Surgery
Department of Thoracic and Cardiovascular Surgery Division of Plastic Surgery
University of Texas University of Toronto
MD Anderson Cancer Center Sunnybrook Health Sciences Centre
Houston, Texas Toronto, Ontario, Canada
Ginger E. Holt, MD Howard W. Jones III, MD
Associate Professor Professor and Chairman
Department of Orthopaedic Surgery Department of Obstetrics and Gynecology
Vanderbilt Orthopaedic Institute Vanderbilt University School of Medicine
Nashville, Tennessee Nashville, Tennessee
Michael D. Holzman, MD, MPH Bellal Joseph, MD
Professor of Surgery Associate Professor of Surgery
Department of Surgery University of Arizona
Vanderbilt University Medical Center Tucson, Arizona
Nashville, Tennessee
Lauren C. Kane, MD
Michael S. Hu, MD, MPH, MS Associate Surgeon
Post-Doctoral Fellow Texas Children’s Hospital
Division of Plastic and Reconstructive Surgery Assistant Professor of Surgery and Pediatrics
Department of Surgery Baylor College of Medicine
Stanford University School of Medicine Houston, Texas
Stanford, California
General Surgery Resident Jae Y. Kim, MD
Department of Surgery Assistant Professor
John A. Burns School of Medicine Division of Thoracic Surgery
University of Hawaii City of Hope Cancer Center
Honolulu, Hawaii Duarte, California
Eric S. Hungness, MD, FACS Charles W. Kimbrough, MD
Associate Professor of Surgery and Medical Education The Hiram C. Polk, Jr., MD Department of Surgery
S. David Stulberg Research Professor University of Louisville School of Medicine
Northwestern University Louisville, Kentucky
Feinberg School of Medicine
Chicago, Illinois Mahmoud N. Kulaylat, MD
Associate Professor
Kelly K. Hunt, MD Department of Surgery
Professor Jacobs School of Medicine and Biomedical Sciences
Department of Breast Surgical Oncology University of New York—Buffalo
University of Texas Buffalo, New York
MD Anderson Cancer Center
Houston, Texas Terry C. Lairmore, MD
Professor of Surgery
Jeffrey Indes, MD, FACS Director, Division of Surgical Oncology
Assistant Professor of Surgery and Radiology Baylor Scott and White Healthcare
Associate Program Director, Vascular Surgery Texas A&M University System Health Science Center
Yale University School of Medicine College of Medicine
New Haven, Connecticut Temple, Texas
Patrick G. Jackson, MD, FACS Christian P. Larsen, MD, DPhil
Assistant Professor of Surgery Dean and Vice President for Health Affairs
Chief, Division of General Surgery Mason Professor of Transplantation Surgery
MedStar Georgetown University Hospital Emory Transplant Center
Washington, DC Department of Surgery
Emory University School of Medicine
Eric H. Jensen, MD Atlanta, Georgia
Assistant Professor of Surgery
University of Minnesota
Minneapolis, Minnesota
xi