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The Gastrointestinal Surgical Patient: Preoperative and Postoperative Care
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Eamonn M. Quigley and Michael F. Sorrell; eds. 554 pages. Baltimore: Williams & Wilkins; 1994. $85.00.
This book is intended to fill a void in the field of gastrointestinal surgery by providing a comprehensive guide to the contemporary medical care of the patient having such surgery. Major advances in the field have created many therapeutic options for today's clinician. Yet, to date, no book has specifically brought together gastroenterologists and gastrointestinal surgeons to create a guide for the clinician.
The book is divided into three parts: Preoperative Assessment (chapters 1 and 2), Major Postoperative Problems (chapters 3 to 10), and Problems Related to Specific Procedures (Chapters 11 to 21). Each chapter is written by different authors. The format is a welcome relief from traditional texts on surgical topics; for example, the so-called principles of surgery are well integrated into the discussion of topics. The book is clearly written and easy to follow and avoids the massive indigestible tables of lists that often plague texts. The one exception is Table 7-4 in the chapter on nutrition support. The topics chosen are clinically relevant and discussion of them covers the basics. When the literature does not clearly define options, several chapter editors resort to "how I do it," but references allow the reader to make an independent appraisal.
The chapters have different styles of organization. For example, in section II, the chapter on biliary surgery focuses on post-operative issues; other chapters in this section cover preoperative, perioperative, and postoperative issues for each major procedure. Some chapters are more encyclopedic than others, but in proportion to the prevalence and importance of the topic. These include chapters on preoperative assessment, colonic surgery, and medical care of inflammatory bowel disease. Illustrations are few.
The book was disappointing in two respects. Two chapters, "Nutrition: Preoperative Nutritional Assessment" and "Nutritional Support" are not well cross-referenced with other chapters. One must read most of the material to find specific issues, which makes the book less than useful as a quick reference; the index, which is not exhaustive, does not help. There are some unfortunate omissions; little is included on the acquired immunodeficiency syndrome (AIDS) in the surgical population or on anal and rectal problems in homosexual men.
This book meets its goal and is a welcome addition. However, it is better suited as a basic text for trainees in internal medicine, junior gastrointestinal trainees, and practicing generalists who have regular contact with patients having surgery. It could also serve as a reference for primary care physicians and other health professionals who do not have daily contact with gastrointestinal surgical problems.
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