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Ann Thorac Surg 2001;71:404
© 2001 The Society of Thoracic Surgeons
a Jersey City, New Jersey, USA
This text in the ever-expanding field of general thoracic surgery consists of 80, small, easy-reading chapters designed as a " ... quick reference for senior medical students ... and other postgraduate trainees... ." Compare it for instance with the 2000 5th edition of the Shields text, General Thoracic Surgery, Fifth Edition (Philadelphia, PA: Lippincott Williams & Wilkins) consisting of 2,500 pages, which "should be used when further detail is needed... ."
At the end of each three- to six-page chapter, suggested further reading and cross references to other chapters of the text are very helpful indeed.
The chapters on achalasia, adult respiratory distress syndrome, anesthesia, bronchoscopy, antireflux surgery, and Barrett’s esophagus are the little jewels of the book written by recognized master surgeons and anesthetists. However, mention could have been made in the text and in the index of emergency complications of gastroesophageal reflux such as serious hemorrhage, since the house officers reading this book are the first doctors faced with such emergencies. Moreover, a few more details and references might have been given on the stapled, uncut gastroplasty and fundoplication for hiatal hernia, about which a three-decade follow-up has now been available (Demos NJ, Dis Esoph, 1999;12:14) with rather good results. The procedure has been the procedure of choice with surgeons in the Mayo Clinic, Montreal, and in Europe.
The chapter on chylothorax is an excellent précis of this uncommon but important subject. The word "symphysis" could have been used to describe pleural obliteration instead of "synthesis" (page 55, line 14). Mention could also have been made of the role of gastrointestinal hormones in the treatment of chylothorax.
The last chapter dealing with Video-Assisted Thoracic Surgery fails to mention hiatal hernioplasty as a possibility.
The chapters on congenital bronchopulmonary anomalies are again a good summary. The authors could have stimulated the imagination of the young readers by mentioning the unified concept of the theory of development of these abnormalities.
The several chapters on reflux stress the importance and value of an esophagram and gastrointestinal x-rays which are all but forgotten by gastroenterologists. The chapter on pectus excavatum could have mentioned the simple strut elevation, Nuss procedure, performed in recent years.
Excellent coverage is given on esophageal cancer staging and treatment. Even though the subject is frequently depressing, we are frequently called upon to palliate the patient’s symptoms. Quality of life could be stressed a bit more. The high incidence of post-resection gastroesophageal and oral reflux and aspiration, up to 65% in the Chinese, Boston and Mayo Clinic experiences, could have been dealt with and methods mentioned to prevent it, such as the intercostal pedicle procedure (Dis Esoph 1995;8:142) with which we now have a three-decade-long experience.
The chapter on lung cancer chemotherapy is the very first of ten chapters on lung cancer probably heralding a depressing outlook. Lung transplantation, surgery for emphysema, mediastinal tumors, corrosive esophageal injury and cricopharyngeal disorders are succinctly covered.
Even though this text is written for young students and house officers to whom I wholeheartedly recommend it, I plan to consult it myself as a quick reference.
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