Associate Editors ix
Contributors xi
Optimal Surgical Treatment for Type 2 Diabetes: Sleeve Gastrectomy or Gastric Bypass?
Amanda Mueller, Sarah Palilla, and Jonathan Carter
Introduction 1
Clinical evidence from randomized, controlled trials 2
The physiology of obesity as it relates to diabetes 3
Mechanisms of diabetes resolution after sleeve gastrectomy or gastric bypass 4
Ghrelin 4
PYY3-36 5
Incretins 5
Bile acids and gut microbiome 5
Duodenal bypass 6
Summary 6
Disclosure 7
Advances in the Diagnosis and Management of Appendicitis in Children
Katherine He and Shawn J. Rangel
Introduction 9
Relevance and approach to severity classification 10
Diagnostic evaluation 10
Diagnostic utility of clinical prediction rules and clinical scoring systems 11
Strategies to optimize the diagnostic quality of US 13
Strategies to leverage the combined predictive value of US, laboratory and clinical data 13
Role of standardized diagnostic clinical pathways 13
Surgical management 16
Influence of operative timing on outcomes and resource utilization 16
Operative approach 16
Initial medical versus operative management for complicated appendicitis 16
Role of irrigation and drains 18
Antibiotic management of uncomplicated appendicitis 18
Antibiotic management for complicated appendicitis 19
Screening and management of OSIs 20
Role of parenteral nutrition 21
Indications and timing of interval appendectomy for complicated appendicitis 21
Same-day discharge for patients with uncomplicated appendicitis 22
Approach to perioperative pain management 22
Medical management as definitive treatment for early appendicitis 22
Outcome, process, and resource utilization benchmarks 27
Future directions and priorities 27
Clinics care points 29
Disclosure 29
Malignant Bowel Obstruction
Nadege T. Fackche and Fabian M. Johnston
Introduction 35
Epidemiology and pathophysiology 36
Evaluation of the patient with malignant bowel obstruction 36
Management 38
Medical therapy 38
Interventional palliation 41
Surgical Palliation 42
Summary 43
Clinics care points 44
Disclosure 44
Nonoperative Treatment of Diverticulitis
Matthew Symer and Heather L. Yeo
Introduction 49
Epidemiology 50
Diverticulitis recurrence 51
Advantages of the nonoperative approach 51
Uncomplicated diverticulitis 52
Complicated diverticulitis 52
Symptomatic uncomplicated diverticular disease and chronic abdominal pain 53
Need for endoscopic examination 53
Summary 53
Clinics care points 54
The Current Management of Visceral Artery Aneurysms
Bara Zuhaili and James H. Black III
Background 57
Anatomic distribution 57
Causes 58
Clinical presentation 58
Nonruptured visceral artery aneurysm 58
Ruptured visceral artery aneurysm 58
Physical examination 58
Work-up 58
Medical treatment 59
Interventional treatment 59
Indication for intervention 59
Intervention options 59
Surgical and endovascular techniques 60
Splenic artery aneurysm 60
Hepatic artery aneurysm 62
Superior mesenteric artery aneurysm 63
Pancreaticoduodenal and gastroduodenal artery aneurysms 64
Gastric/gastroepiploic artery aneurysms 66
Jejunal, ileal, and colic artery aneurysms 66
Renal artery aneurysms 67
Complications/long-term outcomes 68
Long-term recommendations 70
New developments 70
Clinics care points 71
Mesenteric Ischemia: When and How to Revascularize
Kristofor A. Olson and Pedro G. Teixeira
Introduction 75
Anatomy 76
Acute mesenteric ischemia 76
Epidemiology 76
Pathogenesis 76
Clinical presentation 77
Management of acute thrombotic or embolic mesenteric ischemia 77
Management of mesenteric venous thrombosis 82
Medical management 82
Indications for interventions 82
Open surgical versus endovascular 82
Management of non-occlusive mesenteric ischemia 82
Chronic mesenteric ischemia 83
Epidemiology and pathogenesis 83
Clinical presentation 83
Medical management 83
Indications for interventions 83
Surgical versus endovascular 83
Postoperative care 84
Long-term follow-up 85
Summary 85
Clinics care points 85
Watch-and-wait Management for Rectal Cancer After Clinical Complete Response to Neoadjuvant Therapy
Jonathan B. Yuval and Julio Garcia-Aguilar
Introduction 90
Terminology 91
History of watch and wait 91
Patient perspectives on watch and wait 92
Patient evaluation 92
Work-up 92
Selection of patients based on tumor stage 92
Selection of patients based on tumor location 93
Baseline characteristics associated with response to neoadjuvant therapy 93
Radiotherapy regimens 93
Enhancing the response to neoadjuvant therapy 94
Interval to assessment 94
Radiation dose 95
Addition of neoadjuvant systemic chemotherapy 95
Induction versus consolidation chemotherapy in total neoadjuvant therapy 96
Complications of neoadjuvant therapy 96
Assessment of response 97
Long-term monitoring of response 97
Long-term outcomes 97
Oncological outcomes 97
Rates of organ preservation 100
Functional outcomes 100
Summary, discussion, and future directions 103
Clinics care points 104
Disclosure 104
Financial support 104
Paraesophageal Hernia: Current Management
Laura Mazer and Dana A. Telem
Introduction 109
Presentation 110
Diagnosis 111
Indications for repair 112
Management of acute presentation 113
Surgical repair 114
Need for esophageal lengthening procedure 118
Need for gastropexy 119
Summary 119
Disclosure 119
Surgery During a Pandemic: Guidelines
Cole S. Brown and Andrew M. Cameron
Introduction: COVID-19’s impact on health care systems: shutdown of elective procedures 123
After the shutdown: guidelines for ramping back up safely 124
Overview 124
Priorities 124
Acuity 125
Supplies 126
Capacity 126
An unpredictable pandemic: guidelines for ramping back down as needed 127
Guidelines on other important considerations 128
Patient placement and bed management 128
Infection prevention obligations and social distancing 128
Patient and visitor flow 129
Preoperative screening 129
Staff safety and well-being 129
Summary on guidelines for surgery in the time of pandemic 130
Disclosure 130
The Role of Node Dissection for Thyroid Cancer
Reese W. Randle and Susan C. Pitt
Background 131
Epidemiology 132
Patient evaluation overview 132
Initial evaluation 132
Evaluation for recurrence 132
Lymph node imaging 133
Functional imaging 134
Lymph node biopsy 134
Treatment options 134
Central neck dissection 136
Lateral neck dissection 137
Reoperative neck dissection 139
Evaluation of outcomes 139
Complications 139
Completeness of resection 140
Recurrence 141
Survival 141
Long-term recommendations 141
Surveillance 141
Adjuvant RAI 141
Summary 141
Future directions 142
Clinics care points 142
Disclosure 142
Multimodal Pain Control in Surgery 2020
Hannah Decker, Christopher L. Wu, and Elizabeth Wick
Introduction 147
Discussion 149
Nonsteroidal anti-inflammatory agents 149
Acetaminophen 150
Gabapentinoids 150
N-methyl-d-aspartate antagonists 151
Local anesthetics 152
Regional anesthesia/analgesia 153
Summary 153
Clinics care points 154
Disclosure 154
What is the Current Role of Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer?
Catherine H. Davis and H. Richard Alexander Jr.
Clinical background 159
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy technique 160
Historical perspective: survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for patients with colorectal cancer peritoneal metastasis 161
Toxicity and morbidity associated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy 163
Current status of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer peritoneal metastasis 167
Mitomycin C versus oxaliplatin 167
Use of systemic chemotherapy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy 168
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone 169
Hyperthermic intraperitoneal chemotherapy as prophylactic therapy 170
Summary 170
Clinics care points 171
Disclosure 171
Machine Perfusion in Liver Transplantation
Malcolm MacConmara and Parsia A. Vagefi
Video content accompanies this article at http://www.advancessurgery.com
Introduction 175
History of organ preservation 176
Early experimental work with machine perfusion 176
Contemporary advances in machine perfusion 177
Types of machine perfusion of the liver 177
Hypothermic perfusion 177
Normothermic machine perfusion 178
Advantages of machine perfusion 178
Technique of machine perfusion 178
Preparation for perfusion 178
Assessment of donor organs 179
Clinical trials 179
Hypothermic machine perfusion 179
Normothermic machine perfusion 182
Current status of clinical practice in the United States 185
Trends in normothermic machine perfusion application 185
Normothermic machine perfusion of marginal organs 186
Cost and organ allocation 186
Biomarkers 186
Current biomarkers 186
Novel biomarkers 187
Composite viability scores 187
Future advances 188
Expanding marginal livers 188
Enhancing livers 189
Integration with other novel technologies 190
Summary 191
Clinics care points 191
Conflicts of interest 191
Supplementary data 191
What Is the Proper Technique for Primary Laparotomy Closure?
Charlotte Horne and Eric Pauli
Introduction 197
What layer(s) should be closed? 198
How should the linea alba be sutured? 199
Proper fascial closure technique 207
Closure adjuncts 209
Summary and recommendations 211
Clinics care points 211
Disclosure 212
Can Pancreatic Organoids Help in the Treatment of Pancreatic Cancer?
Toni T. Seppälä and Richard A. Burkhart
Video content accompanies this article at http://www.advancessurgery.com
Introduction 215
Nature of the problem 216
Significance (in depth analysis) 216
What biomarkers predict treatment response? 216
What is an organoid? 218
Capacity to model human disease 219
How to make use of the pure ductal cancer cell population? 220
Success rates in organoid establishment protocols 222
How are pancreatic ductal adenocarcinoma organoids used currently in research? 223
Proposed frameworks of care 225
Barriers to clinical implementation today and strategies for the future 226
Summary 227
Clinics care points 227
Disclosure 227
Supplementary material 227
Necrosectomy in the Management of Necrotizing Pancreatitis
Amy Y. Li, John R. Bergquist, and Brendan C. Visser
Video content accompanies this article at http://www.advancessurgery.com
Introduction 232
Background and definitions 232
Indications and timing for necrosectomy 233
Approaches to necrosectomy 235
Open necrosectomy 236
Laparoscopic necrosectomy 237
Retroperitoneal debridement 238
Endoscopic transgastric drainage and necrosectomy 240
Surgical transgastric necrosectomy 242
Percutaneous drainage 245
Summary 245
Clinics care points 246
Acknowledgments 246
Supplementary data 246
Vascular Reconstructions for Traumatic Injuries
Ali Khalifeh and Todd E. Rasmussen
Introduction 251
Diagnosis and initial management 252
Mechanism of Injuries and Diagnosis 252
Operating Room and Setup 255
Temporary Vascular Shunts 256
Endovascular Balloon Occlusion of The Aorta 257
Other Types of Balloon Occlusion 258
Endovascular Repair of Vascular Trauma 258
Conduits for Vascular Reconstruction 259
Anticoagulation and Antiplatelet Use 262
Anatomic regions 262
Extremity injuries 262
Cervical 264
Torso 266
Summary 269
Clinics care points 269
Evolution of Point-Of-Care Ultrasound in Surgical Management
William A. Teeter and Thomas Scalea
Focused assessment with sonography for trauma 273
Patient placement 274
Evaluation of the heart and pericardium 275
Subxiphoid view 275
Parasternal long view 276
Morison's's pouch 276
Splenorenal recess 277
Pouch of Douglas 277
Thoracic views 278
Cardiac ultrasound 280
Parasternal long view 280
Parasternal short view 284
Apical four-chamber and five-chamber views 287
Assessment of hypovolemia using cardiac ultrasound 288
Intravascular catheter placement 289
Summary 294
Clinics care points: fast 295
Disclosure 295
Breast Implant–Associated Anaplastic Large Cell Lymphoma
Melissa Camp
Introduction 299
Background 300
Epidemiology 300
Presentation 301
Diagnosis and workup 301
Treatment 302
Staging 303
Food and Drug Administration warnings on implants 303
Management of patients who currently have implants 303
Summary/Conclusions 304
Clinics care points 305
Disclosure 305
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