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Ann Thorac Surg 2001;71:380
© 2001 The Society of Thoracic Surgeons
a Stanford, California, USA
If bigger is truly better (and in this case it may well be), Dr Shields has presented us with a real blockbuster. After an interval of six years, this, the fifth edition of this comprehensive and important book, now has almost 2,600 pages (up from 1,994), 190 chapters (up from 136), 29 sections (up from 24), 213 contributing authors (up from 143) and two new editors (up from none). I wonder if this latter fact means that this is Dr Shields’ last effort as editor and that he intends to turn over the reins of editorship to one or both of the other editors or even someone else. Only time will tell.
As is the case in all multi-authored texts, there is considerable variability in writing style, length of chapters, illustrations and emphasis. It is an impossible and not necessarily desirable task to have uniformity in a text such as this one. If an editor is to gather authoritative contributors, one must give them some leeway in a number of areas. When one has persuaded acknowledged experts in their fields such as Pairolero, Light, Sugarbaker, Sahn, Grillo and Goldstraw to contribute to your work, it is best to cut them a little slack if you want them to contribute again. And their chapters were wonderful.
Some additional chapters are superb. Shamberger’s Chapter 40 on chest wall deformities is one. Backer’s on tracheal compression by vascular rings is another although, at first glance, the relevance might seem to be borderline. But there are imbalances. Seventeen pages on radionuclide studies of the mediastinum seems a bit excessive considering the fact that only 23 pages are devoted to all the rest of the imaging studies, ie, x-ray, CT and MRI. That is really a minor criticism but an obvious one. Four chapters adding up to over 50 pages on mycotic and actinomycotic infections, amebiasis, hydatid disease and paragonamiasis but only 10 pages on Barrett’s esophagus is a real imbalance. But this incongruity has a sunny side. No textbook, no matter how large, can be the reference of last resort on everything. There are many places where one can readily find current information on cancer of the lung. Section XV in this text is one of them. But if a thoracic surgeon is looking for information on the rare infections noted above, he or she may have to look no further than Shields’ contribution. If, on the other hand, definitive information on Barrett’s esophagus is being sought, one will have to read further even though Ellis is the senior author of the chapter.
Many of the illustrations are familiar, chiefly because they have appeared elsewhere. Color renditions, admittedly expensive, would have improved some of the photographs, especially the operative ones. While many of the photographs of radiographs are excellent, some are not up to par. But we generally got the idea being presented anyhow.
Some of the chapters at first glance seem to be peripheral to the main thrust of the book and in some ways they are, but in many cases these are the very ones that will be of most use to the thoracic surgical student, early or late in his or her career. I refer to those on cellular and molecular biology by Steve Mentzer, mediastinal tumor markers by Phillip Robinson, biologic markers and pathology of lymphoma by Michael Kornstein and the appendix on statistics by Robert Stewart and Christian Campos. And the chapters on surgical technique will provide ready reference to those in need "the night before".
Everyone whose professional life is devoted to general thoracic surgery should have access to this text and many should own it. Others who are sometimes involved in the care of thoracic surgical patients, be they students, general surgery residents or specialists in fields related to thoracic surgery, should also have access to this book. It is up-to-date, at least as much as a textbook can be, and should hold up well until the next edition is published.
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