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Plastic and Orbital
Surgery
Edited by Richard
Collin and
Geoffrey Rose.
BMJ Books
ISBN 0-7279-1475-8
£55.00
This book has been written for ophthalmic trainees and general ophthalmologists wishing to update their
knowledge of oculoplastic surgery. Each chapter has been written by a separate author
each of who have worked with the two editors at Moorfields hospital. The content
is pertinent and well presented. Each of the surgical procedures is clearly described
and is accompanied by excellent diagrams. Pathological conditions are well illustrated by
clinical photography. Each section contains suggestions for further reading. The chapter on
periocular malignancy is particularly good as is the section on the investigation of lacrimal
and orbital disease.
In summary, Plastic and Orbtial Surgery provides a succinct, well written and up-to-date account of eyelid, lacrimal and orbital surgery and is highly recommended.
Dr Mark Wright Princess Alexandra Eye Pavillion, Edinburgh, Scotland
Chassin’s Operative
Strategy in General
Surgery.
Third
Edition, Edited by Carol
E H Scott- Conner.
Springer-Verlag ISBN
0-387-95204-7
£125.50
This is the third edition of an operative surgery atlas originally written by an
American surgeon Jameson L Chassin in 1980. Although the original book was written
by a single author a new editor and 13 surgeons have been recruited to complete this edition. The book has 961 pages and
1065 illustrations and attempts to cover the important operations within general surgery.
The scope of the book as cited in the preface is to serve “ all clinical surgeons, both those
in training and those in surgical practice” by “specifically discussing the conceptual
basis of the operation as well as the strategy that will help the surgeon avoid common
pitfalls”.
How well does the book measure up to these aims? Firstly, although most of the diagrams are well done and illustrate the intended operative detail adequately I find the monochrome illustrative style a little “tired”. Secondly, the scope of the atlas is interesting in that the editor attempts to cover the entire scope of general surgery in one volume. Does this succeed? There are undoubted strengths and weaknesses. The structure of the book is excellent and I find the sections on concepts and strategies before dealing with the operative surgery of each organ to be worthwhile. The authors have by and large covered their subjects well. However, what I do find surprising is the choice of operations which have been included in the book and even more importantly which have been left out. In the section on oesophageal surgery the only 2 laparoscopic procedures included are Nissen fundoplication and Heller’s operation. The surgical treatment of paraoesophageal hernia (either laparoscopic or open) is not even mentioned. In contrast, the open Hill operation for gastrooesophageal reflux disease (an operation which must only rarely be done in 2002) is allocated 8 pages.
The coverage given to the expanding role of laparoscopic surgery in the atlas is very thin indeed. In an era when most surgeons who are serious about splenic surgery will be performing the majority of their operations laparoscopically this book deals with laparoscopic splenectomy in a few lines. One of the first sections I dipped into was the large bowel section to read about the latest views on laparoscopic colorectal surgery. Imagine my surprise when I found only a brief reference to this subject. My own conclusion is that the editor could easily have left out some of the “surgical legacy” procedures (operations which are rarely performed these days) and given much wider coverage to current laparoscopic surgical practice.
With regard to the chapter contents I found most of them to be very good with lots of practical hints. However, there are weak areas. Mobilisation of the thoracic oesophagus during the technique of oesophagectomy using right thoracotomy and laparotomy is described in a mere 150 words and ligation of the thoracic duct during this procedure is not even mentioned.
Should you go out and buy this book? It depends on what your needs are. If you are looking for a volume which gives good descriptions of standard open operations (and some which are now rarely performed) the answer is yes. If on the other hand you are looking for information on how to perform the spectrum of surgery (including newer laparoscopic procedures) relevant to general surgical practice in 2002 you may find the volume disappointing.
Mr Alasdair Munro Raigmore Hospital, Inverness, Scotland
Drugs in Sport
- the pressure to
perform.
BMJ Books
ISBN 0-7279-1606-8
£16.94
“A minute’s success pays the failure of years”. Apollo and The Faites Robert
Browning 1812-1899
Pressure to perform in sport is not new. Winning the Olympic Games in Ancient Greece could bring fame and fortune of Beckhamesque proportions. It is reported that athletes of the time would ingest any preparation, plant or compound to boost their chances of winning. Life has come full circle. Over the past 100 years organised sport has changed dramatically. Once there was amateur endeavour with scant reward. (“The most important thing in the Olympic Games is not to win but to take part, just as the most important thing in life is not the triumph but the struggle. The essential thing is not to have conquered but to have fought well.” De Coubertain 1896). Now there are professionals with massive rewards. As with the ancient Greeks, these rewards are primarily financial, but success also brings status. The temptation, therefore, to enhance performance artificially has never been stronger. Indeed the Olympic Motto urges perfection: “Citius, Altius, Fortius” (Faster, Higher, Stronger).
Unfortunately, the modern pharmaceutical industry is considerably more sophisticated than that of the ancient Greeks and Romans. Who could have foreseen the almost simultaneous introduction or erythropoeitin for treatment of the anaemia of renal failure and blood doping?
Most of the athletes caught with banned substances in their urine (there is little blood testing done) will have one of the following as a cause:
• Deliberate use of banned substances as ergogenic aids
• Accidental contamination e.g. sitting beside someone smoking cannabis
• Unintentional as in unwitting ingestion of a banned compound in an over the counter preparation available to the general public
• Unintentional as in legal prescription by a medical practitioner of a standard medicant but which is on the banned list
The last two mentioned mean that it is incumbent on every medical practitioner who has reason to attend a sportsman for any reason, to be familiar with the modern concept of doping in sport. Just as important is knowledge regarding just what is permissible therapy and what is banned.
To this end, the current publication by the British Medical Association is both timely and appropriate. All current aspects of drugs in sport are covered in a readable and lucid fashion, including a section on the various attitudes on doping. The legal situation relating to doping is brief but clear. As with other sections the references allow the interested reader to pursue further detail. I particularly welcome the appendices that explain the dope testing as it pertains to the UK, both for the athlete and the laboratory. This section should be compulsory reading for all team doctors, who will at some time have to help their players or athletes through a testing scenario.
The internationally accepted classification of drugs allowed or banned (produced by the International Olympic Committee) is well presented and comprehensive (Chapter 3). It should be noted that this list is regularly updated, which means that reliance on this section could lead to unsafe practice. For instance, the recent changes in regulations on ß2 - agonist usage have been the cause of several “misunderstandings” recently. Those actively involved in sport should receive updates from relevant governing bodies, but the book does highlight sources of advice for others.
Overall, this is an excellent book that deserves wide readership, not only by medical personnel, but by administrators, coaches and trainers involved with all categories of athlete.
Dr Tom Beattie Royal Hospital for Sick Children, Edinburgh, Scotland