| Contributors | p. ix |
| The Whipple Operation: Is a Radical Resection of Benefit? | p. 1 |
| Background | p. 2 |
| The Johns Hopkins Prospective, Randomized Study | p. 7 |
| Surgical Technique | p. 7 |
| Postoperative Management and End Points | p. 11 |
| Study Results | p. 11 |
| Discussion of Primary End Points | p. 18 |
| Secondary End Point: Quality of Life in Pancreaticoduodenectomy Survivors | p. 20 |
| How Can We Improve Outcomes? | p. 23 |
| Current Status of Hepatic Resection | p. 29 |
| Historical Insights | p. 30 |
| Recent Advances in Hepatic Resection | p. 31 |
| Indications and Patient Selection | p. 36 |
| Techniques | p. 40 |
| Vascular Control | p. 40 |
| Parenchymal Transection | p. 41 |
| Portal Vein Embolization | p. 42 |
| Minimally Invasive Techniques | p. 43 |
| Summary | p. 44 |
| Stem Cells: What Is Their Future in Surgery? | p. 51 |
| Overview/History | p. 51 |
| Applications of Stem Cells in Surgery | p. 54 |
| Cardiac Surgery | p. 54 |
| Neurosurgery | p. 56 |
| Transplant Surgery | p. 58 |
| Gastrointestinal Surgery | p. 60 |
| Plastic and Reconstructive Surgery | p. 62 |
| Fetal Surgery | p. 63 |
| Legal and Ethical Issues in Stem Cell Research | p. 64 |
| Conclusions | p. 65 |
| Acknowledgments | p. 65 |
| Surgical Treatment of Colon Cancer: Does Sentinel Node Technology Have a Role? | p. 71 |
| Interaction Between Tumor and the Lymphatic System | p. 72 |
| Prognostic Significance of Lymph Nodal Involvement and Role of Lymphadenectomy | p. 73 |
| Role of Adjuvant Therapy in Stage III Disease | p. 74 |
| Accuracy of Current Staging Procedures and Methods of Identification of Lymph Nodes | p. 74 |
| Sentinel Node Mapping Procedures for Cancer | p. 76 |
| Technique of Sentinel Lymph Node Mapping | p. 77 |
| Skip Metastases as a Confounding Factor in the Efficacy of Sentinel Nodes as Representatives of the Nodal Basin | p. 78 |
| Scope of Sentinel Nodes in Colorectal Cancer | p. 79 |
| Significance of Micrometastases | p. 81 |
| Prognostic Effect of Micrometastases in Colorectal Carcinoma | p. 82 |
| Studies on Sentinel Nodes in Colorectal Cancer | p. 83 |
| In Vivo Studies | p. 83 |
| Ex Vivo Studies | p. 85 |
| Studies Using a Combination of Both In Vivo and Ex Vivo Techniques | p. 85 |
| Conclusion | p. 86 |
| Current Treatment of Gastric Cancer: Is Adjuvant Therapy of Benefit? | p. 95 |
| Adjuvant Chemotherapy | p. 97 |
| Meta-analyses of Adjuvant Chemotherapy | p. 101 |
| Adjuvant Radiotherapy | p. 102 |
| Adjuvant Chemoradiotherapy | p. 103 |
| Immunotherapy | p. 106 |
| Intraperitoneal Chemotherapy | p. 109 |
| Neoadjuvant Therapy | p. 112 |
| Future Directions | p. 114 |
| The Management of Traumatic Aortic Rupture | p. 123 |
| Mechanism of Injury | p. 124 |
| Patients at Higher Risk of TAR | p. 125 |
| Patient Screening | p. 125 |
| Screening by Helical Computed Tomography Scan | p. 126 |
| Current Management Strategy | p. 127 |
| Discussion | p. 130 |
| Timing of Surgery | p. 130 |
| Use of Bypass | p. 132 |
| Use of Stents for Repair of TAR | p. 133 |
| Conclusions | p. 134 |
| Melanoma: Is Immunotherapy of Benefit? | p. 139 |
| Immune System in Melanoma | p. 142 |
| Melanoma Immunotherapy Strategies | p. 143 |
| Adoptive vs Active Immunotherapy | p. 145 |
| Specific vs Nonspecific Immunotherapy | p. 145 |
| Target Antigens for Specific Immunotherapy | p. 146 |
| Is Immunotherapy of Benefit? | p. 148 |
| Local and Regional Therapy | p. 148 |
| Systemic Cytokine Therapy | p. 149 |
| Adoptive Transfer: TILs | p. 151 |
| Vaccines | p. 151 |
| Conclusion | p. 161 |
| Colon Cancer: Do We Need a Staging System? | p. 171 |
| Barrett's Esophagus: Current Status of Treatment | p. 179 |
| Clinical Features | p. 180 |
| Pathophysiology | p. 181 |
| Diagnosis | p. 183 |
| Treatment of Gastroesophageal Reflux | p. 184 |
| Screening and Surveillance | p. 186 |
| Dysplasia | p. 188 |
| Treatment Options | p. 189 |
| Treatment Guidelines | p. 191 |
| Conclusions | p. 192 |
| Clinical Implications of Hereditary Breast Cancer | p. 197 |
| BRCA1/BRCA2 | p. 198 |
| Li-Fraumeni, Peutz-Jegher, Muir-Torre/HNPCC and Cowden Disease | p. 198 |
| What Chromosomal Abnormalities Cause Hereditary Breast Cancer? | p. 199 |
| How Common Is Hereditary Breast Cancer? | p. 201 |
| How Is the Risk for Hereditary Breast Cancer Assessed? | p. 201 |
| Who Should Undergo Genetic Testing? | p. 204 |
| What Are the Treatment Options for Patients With Hereditary Breast Cancer? | p. 205 |
| Surveillance | p. 206 |
| Risk-Reducing Surgery | p. 206 |
| Chemoprevention | p. 208 |
| How Are Breast Cancers in BRCA-Positive Women Treated? | p. 209 |
| What if a Genetic Mutation Is Not Found? | p. 209 |
| Paraesophageal Hernia: When to Operate? | p. 213 |
| Pathophysiology | p. 214 |
| Incidence and Diagnosis | p. 215 |
| Treatment | p. 218 |
| Indications for Elective Surgery | p. 220 |
| Conclusion | p. 227 |
| Current Methods of Bowel-Sparing Surgery in Crohn's Disease | p. 231 |
| Indications and Contraindications for Bowel-Sparing Surgery in Crohn's Disease | p. 232 |
| Preoperative Evaluation and Preparation | p. 233 |
| Operative Strategy and Technique | p. 233 |
| Heineke-Mikulicz Strictureplasty | p. 234 |
| Finney Strictureplasty | p. 237 |
| Side-to-Side Isoperistaltic Strictureplasty | p. 238 |
| Strategy According to Specific Clinical Presentations | p. 243 |
| Gastroduodenal Crohn's Disease | p. 243 |
| Recurrent Anastomotic Stricture | p. 244 |
| Colonic Crohn's Disease | p. 244 |
| Pediatric Crohn's Disease | p. 244 |
| Results of Bowel-Sparing Surgery in Crohn's Disease | p. 245 |
| Conclusions | p. 248 |
| Current Status of Islet Cell Transplantation | p. 253 |
| Providing an Islet Graft: The Islet Isolation Procedure | p. 255 |
| Searching for the Unlimited Islet Supply | p. 259 |
| Lessons Learned From Autologous Islet Transplants | p. 262 |
| Early Clinical Trials of Allogeneic Islet Transplantation in Uremic Type 1 Diabetic Patients | p. 265 |
| Islet Allotransplantation Alone in Nonuremic Type 1 Diabetic Patients | p. 267 |
| Future Perspectives: Immune Tolerance or Immunoprotective Devices? | p. 271 |
| Current Management of Intestinal Fistulas | p. 283 |
| Etiology | p. 283 |
| Prevention | p. 284 |
| Causes of Morbidity and Mortality | p. 284 |
| Management | p. 286 |
| Stabilization | p. 287 |
| Investigation | p. 292 |
| Decision | p. 293 |
| Definitive Therapy or Operation | p. 294 |
| Healing | p. 298 |
| Endoluminal Graft Repair for Abdominal Aortic Aneurysms | p. 301 |
| Preoperative Evaluation | p. 302 |
| Device Implantation | p. 307 |
| Device Fixation and Sealing | p. 309 |
| Endoleaks | p. 311 |
| Aortic Endograft Devices | p. 315 |
| Vanguard Device | p. 315 |
| Ancure Device | p. 315 |
| AneuRx | p. 316 |
| Excluder | p. 316 |
| Talent LPS | p. 318 |
| Zenith | p. 318 |
| Endologix | p. 319 |
| Lifepath | p. 319 |
| Cordis Endovascular | p. 319 |
| Patient Selection | p. 320 |
| Postoperative Surveillance | p. 322 |
| Conclusion | p. 322 |
| Addendum | p. 323 |
| Is Imaging Necessary for the Diagnosis of Acute Appendicitis? | p. 327 |
| Plain Radiographs | p. 329 |
| Ultrasound | p. 329 |
| Computed Tomography | p. 331 |
| Magnetic Resonance Imaging | p. 336 |
| Nuclear Medicine Imaging | p. 336 |
| Current Trends In Practice | p. 337 |
| Conclusions | p. 339 |
| Index | p. 347 |
| Table of Contents provided by Rittenhouse. All Rights Reserved. |
